From the Archives: Neuromodulation

Tiefe_Hirnstimulation_-_Sonden_RoeSchaedel_seitlCredit: Hellerhoff/Wikimedia

Some people with Parkinson’s disease or intractible depression have shown great improvement using implanted and external brain stimulation. In our news story “Stimulating the Brain: From If to How,” writer Carl Sherman describes how researchers are diving down, to improve treatment methods and to discover what, exactly, stimulating the brain does:

“The question of how the brain is wired together and functions as units in some sort of coherence pattern is what’s driving everything now,” says Helen Mayberg, professor of psychiatry, neurology, and radiology at Emory University and a member of the Dana Alliance for Brain Initiatives.

We’ve followed the work of Mayberg and others (and funded some of it) over the years,  including publishing a book, Deep Brain Stimulation by Jamie Talan, released in 2009.  More recently, we posted a Q&A with Mayberg on her work with severely depressed people. To qualify for the still-experimental deep brain stimulation (DBS) surgery, a person must have tried multiple drugs and other therapies and found none to help. Here’s a bite:

Somehow the DBS turns off the mental pain, but I have no idea how. We do know that if stimulation is turned off, patients don’t stay well, and it doesn’t matter if you turn it off in the first six months of treatment or after five years of being well. This is most clearly observed when the battery in the stimulator apparatus is depleted: patients gradually (over several weeks) lose their state of wellness, and they recover once the battery is replaced.

That suggests that the stimulation is not curing the underlying problem, but is somehow maintaining the ability of the brain to learn and plan and do all the things that the brain does. DBS restores the brain’s capacity to go in whatever direction you choose, but the choice is yours. When you’re depressed, the choice is not yours.

As with all experimental treatments, researchers caution that this therapy may not work for all people. But the need is so great—severe depression can rob people of chunks of their life, or even push them to suicide—that the temptation is great to say, “Hey, sign me up now.” DBS pioneer (and Dana Alliance member) Mahlon Delong wrote an essay for the Dana Foundation’s online journal Cerebrum in 2009, “Using DBS on the Mind: Handle with Care,” on the push-pull of making good science and making it fast.

The Dana Foundation and the European Dana Alliance for the Brain also sponsored a public talk back in 2006 where scientists explained how DBS works and people who have had the implants talked about their experiences with the devices.

– Nicky Penttila

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