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Brain Implant to (lightning storms) Treat Depression

By Robert Webb

 Deep brain stimulation is a method to alter brain functioning. The idea behind this technology is that scientists implant a small electrode deep within the brain. This electrode delivers controlled jolts of electricity to the surrounding brain tissue. Depending on how it is placed, it can either increase or decrease brain activity in specific areas.

Deep brain stimulation has been used to improve people’s mood. The DBS device has been placed in several different locations to get an antidepressant effect. The area with the most evidence for an antidepressant effect is when the device is placed in an area of the brain called Broadman Area 25. This area is located nearer to the frontal part of the bain. In regular healthy patients increased activation of this area is associated with feelings of profound sadness. People with depression, on the other hand, have abnormally high activity in this area. So a DBS device can reduce activity in this area. In a preliminary study it lead to a striking improvement in patients with major depression. It can reduce the extreme sadness that is associated with the disease.

Researchers have also targeted an area of the brain called the nucleus accumbens. The nucleus accumbens is one of the main reward related regions of the brain. When a DBS device is planted in this area, it can improve anhedonia. Anhedonia is the inability to exprience pleasure, and it is a common trait found in many schizophrenic and depressed paitents. So the DBS device can increase the amount of pleasure a person experiences. A device in this area, though, has little effect on other depressive symptoms. Researchers have also found that a device in this area can potentially make a person euphoric. So they have to be carefull to adjust the device just right so as not to make the person too happy.

There are several other areas that DBS devices have been implanted in to improve mood. Another area is called the globus pallidus. The researchers were actually implanting the device their to improve a movement disorder, but they also found that the patient’s depression improved substantially. The lateral habenula is another area that may have antidepressant properties. An overactive lateral haenular leads to less serotonin, norepinephrine and dopamine in the brain. So decreasing activity there may increase those neurotransmitters and thus improve mood.

Deep brain stimulation carries several risks because a person would have to undergo brain surgery. There is even a minor risk of death involved, so this treatment may always be limitied in scope. However, in the future it may increasingly find use for treatment resistant mental disorders.

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Electromagnetic Brain Stimulation for Addiction
By Robert Webb

 Transcranial magnetic stimulation is a non-invasive way of stimulating many different areas of the brain. Being addicted to drugs has a considerable toll on the individual. Now researchers are begining to use transcranial magnetic stimulation as a treatment for people who are addicted to various drugs. Depression and addiction often overlap on both the symptomatic and chemical level. States of both depression and addiction often share anhedonia the inability to experience pleasure. The reward related regions of the brain are dysregulated in both of these disorders, leaving patients demotivated and unable to really feel anything.

Not only is reward functioning dysfunctional in addiction, but executive functions become problematic. Executive functions include overall ability to properly function in society. These functions include your concentration and motivation. Using TMS, scientists may be able to improve a person’s executive functioning by activating frontal areas of the brain. Scientists may also be able to treat both addiction and depression by targeting similar reward related areas with TMS due to the overlap between the two disorders. One could imagine a future where non-invasive stimulation of reward related regions becomes the norm.

In a recent study, researchers investigated the efficacy of a single session of high frequency transcranial magnetic stimulation TMS to see if it could reduce cocaine craving in people addicted to cocaine. A total of six patients had 10 Hz TMS over both the left and right dorsolateral prefrontal cortex (DLPFC). The researchers found that stimulating the right dorsolateral prefrontal cortex significantly reduced cocaine craving over time. This shows that in the future TMS may be increasingly used as a new treatment modality for a variety of different addictions. It may be able to improve depression symptoms as well among those people.

The company Brainsway is testing their new deep TMS device to target deeper brain areas that are related to the reward system. Researchers in the past have discovered that direct electrical stimulation of a brain area called the nucleus accumbens is rewarding. In both human and animal subjects, electrodes have actually been implanted directly within this brain region. However, this requires a person to undergo risky brain surgery. With deep TMS, psychiatrists may be able to electrically stimulate a person’s nucleus accumbens non-invasively. This would be a way to improve a person’s normal capacity for pleasure.

Using transcranial magnetic stimulation as a treatment for addiction brings up all sorts of fascinating questions. How do you calibrate the hedonic setpoint on a person so as to dole out their pleasure. Will people become addicted to getting their pleasure centers stimulated with electromagnetism. Will we have junkies who want to get their next transcranial magnetic stimulation fix. Or will scientists be able to increase the capacity for reward while reducing the propensity to seek out that reward excessively. These are not easy questions to answer but I think they are ones that we are going to have to face, sooner rather than later. However, TMS definitely shows a lot of promise for disorders of addiction.

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Friday, September 26th, 2008 at 9:16 am and is filed under science. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.