Neurophilosophy

Severe depression treated with deep brain stimulation

Posted by Mo on September 23, 2007
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deep_brain_stimulation.jpg

(Image credit: John B. Carnett) 

The September issue of Popular Science magazine has an article about one of the first clinical trials in which deep brain stimulation is being used to treat patients with severe depression who do not respond to drugs or electroconvulsive therapy.

The image above shows Diane Hire, one of 17 patients enrolled in the trial, which is being conducted at the Cleveland Clinic in Ohio. The X-ray on the right shows the position of the electrodes that have been implanted in Hire’s brain.

According to the article, the procedure takes about 4 hours. It involves drilling two holes in the top of the skull (one on each side; the hole on the left side of the skull is visible in the X-ray), through which the electrodes are fed. The electrodes are powered by batteries that are embedded under the collarbones.

The part of the brain that is targeted is the subgenual cingulate region, a small area found near the midline towards the back of the frontal lobe. Imaging studies have shown that this area is over-active in depression, and an earlier trial showed that continual stimulation of the area produced sustained remission in 4 out of 6 severely depressed patients.

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Comments

  1. #1 Old Bogus
    September 26, 2007

    My immediate reaction is, “Is this for everyone?”. Is there a line to be drawn for direct stimulation of the brain? How ’bout pleasure on demand? Sexual stimulation by electrode? Electrically induced slavery?

    Who decides who gets the wire and where? A step toward transhumanism. Soon the computer interface to the WWW will be a jack we plug ourselves into.

  2. #2 Pup, MD
    September 26, 2007

    Dude, you need to lay off the Philip K Dick. Is this for everyone? No, it’s for folks that failed ECT. It’s a neurosurgical procedure with a zillion risks, but if it has fewer risks than, say, dying from untreatable depression, it’s a good thing. There’s about a 0.001 correlation between this and the weird sci-fi junk you’re talking about.

  3. #3 Dr X
    September 30, 2007

    My immediate reaction is, “Is this for everyone?”. Is there a line to be drawn for direct stimulation of the brain? How ’bout pleasure on demand? Sexual stimulation by electrode? Electrically induced slavery?

    Of course, it isn’t for everyone. No treatment is for everyone and radical treatments like this are not intended to supplant psychotherapy or medications that alleviate the suffering of the majority of patients suffering depression. If you’d ever dealt with a person whose relentless suffering has not responded to intensive psychotherapy, the gamut of medications, medication combinations and ECT, it would be difficult to view this as having anything to do with pleasure on demand or slavery. In the face of such deep, persistent suffering, only a callous heart would associate the relief of such suffering with pleasure on demand or human bondage.

    One could even make the argument that, when it’s the patient’s right to be in charge of his or her own body that is in question, granting governemnt or society at large the authority to refuse a treatment on purely philosophical grounds is itself a form of slavery.

  4. #4 Nix
    October 6, 2007

    Last I heard, the biggest problem with this sort of thing was the infection risk. Has it been reduced to acceptable levels now?

  5. #5 synnolian
    November 24, 2007

    My immediate reaction is, “Is this for everyone?”.
    Of course not !!
    but if it were’t for those responsible for this type of experimental exploration how would we know about it
    I think its absolutely amazing to think of the hours and hours of study discussion and precision thinking thats gone into it and to see and read the final result amazing can only lead through trial and tribulation to bigger and better things to come . Congradulations.
    Technology is great long live Frankenstien

  6. #6 Joseph Brenner
    August 4, 2008

    Is there any potential for Epilepsy patients?

  7. #7 Joe
    January 8, 2010

    Of course, there’s chance for abuse. But I’d be hard pressed to imagine any doctor under normal conditions offering this to patients who wouldn’t benefit. I’d be hard pressed to imagine patients volunteering to risk the real chance of death just to get enhanced pleasure when drugs do the same job. Yes, in some twisted country, medical doctors will perform this against people’s will like political prisoners-but they would do this anyway. So the concern is valid, but the problem is with the society which allows such mistreatment, not the specific procedures.