Brain stimulation may ease stubborn depression

Targeted electrical stimulation of a particular region of the brain can lessen symptoms of major depression that hasn't improved with other treatments, the results of small pilot study suggest.

Previous research has suggested that this region of the brain - called the left dorsolateral prefrontal cortex - plays a key role in the development of major depression, Dr. Emad N. Eskandar told Reuters Health.

"This is the first and only study to investigate the use of an implanted cortical stimulator to treat severe and medically refractory major depression," said Eskandar, from Harvard Medical School, Boston.

Roughly 4 million people in the US have depression that doesn't respond to medication, and so finding alternative treatments is important, he added.

The study, reported this week at the American Association of Neurological Surgeons annual meeting in San Diego, California, included 12 patients who, on average, had depression for 27 years and had not been helped by nine or ten different medications.

To provide brain stimulation, electrodes were placed on the surface of the brain via a small opening in the cranium. The subjects were randomly assigned to get active or sham stimulation for 8 weeks and then all were given active stimulation.

At 8 weeks, scores on a standard depression rating scale improved by 22 percent in the active treatment group compared with just 3 percent in the sham treatment group.

All of the subjects showed continued improvement 6 and 12 months later.

"The take-home message is that there are a number of new approaches to treating major depression, which include deep brain stimulation and cortical stimulation," Eskandar said. "Interested clinicians and patients can seek out studies that are now enrolling patients in specialized centers around the country."

By Anthony J. Brown, MD
NEW YORK (Reuters Health)