Deep brain stimulation - no side effects
Professor Helen Mayberg discusses the systems affected by deep brain stimulation, which seems to relieve depression without side effects.
In some ways, this system isnâ€™t trained, and there is something about the interruption or the pacing or whatever this acute effect is that is a release phenomenon. I think itâ€™s, in essence, a disinhibition; that the cortex has been hijacked, and you are just allowing it to go about itâ€™s business, but that itâ€™s something more than that, because it isnâ€™t just that I get you back on track and you go on your way. There is something about this system that has vulnerability, and it is such an important system to evaluate everything about stress and novelty in your world; are things good for me or bad for me? You always use your emotional monitor to make decisions that it has a tendency to get stuck. So itâ€™s using the normal process, but it doesnâ€™t re-equilibrate and somehow weâ€™ll need to figure out what the electricity chronically is doing that allows the system to actually go about its business, because remarkably we donâ€™t see side effects; there doesnâ€™t seem to be a price you pay to have this continuous stimulation going on all the time in this very vital network. It either works or it doesnâ€™t, but it doesnâ€™t require a higher dose over time, it doesnâ€™t wear out, and it doesnâ€™t give side effects, so the question is what can be wrong that this kind of intervention can just bring things back into normal tolerance limits. And equally remarkably, peopleâ€™s dynamic range emotionally is fine, and one of the most interesting things is that once you have been sick and â€˜deadâ€™ such a long time, the early part of treatment is actually relearning what itâ€™s like to have a bad day. You do have dynamic range; it doesnâ€™t take away your ability to have a bad day, you have to relearn what that feels like because in fact the normal ebbs and flows of normal daily life has emotional ups and downs, and for these patients they are accustomed to being dead and deader with no dynamic range. And now they have to learn that having a bad day is sometimes just having a bad day, and not a relapse. So the retraining process is very critical as well, but itâ€™s just as though this constant stimulation allows the brain to do its job and doesnâ€™t actually charge the person with having to learn to go around something as a price of recovery.
deep brain stimulation, depression, rehabiliation, disinhibition, systems, helen, mayberg
An overview of depression-related content on Genes to Cognition Online.
Professor Helen Mayberg describes the dramatic changes observed in depressed patients treated with deep brain stimulation, discussing how this has impacted how we view the brain and treatment.
Professor Helen Mayberg describes treatments for depression: medication, therapy, or a combination of the two. About 40% of patients recover entirely, while about 10% do not respond.
Professor Helen Mayberg describes the incredible transformation in some patients following deep brain stimulation to treat depression.
Professor Helen Mayberg discusses how deep brain stimulation (DBS) is applied to the subcallosal cingulate, a structure deep in the brain's white matter.
Individual variations in antidepressant treatment outcomes.
Professor Helen Mayberg describes a network of structures linked to depression - the cingulate, hypothalamus, brainstem, and amygdala. These are influenced by frontal and parietal cortices.
Doctor Abraham Zangen discusses two techniques for treating depression, which involve electrically stimulating the brain - transcranial magnietic stimulation (TMS) and deep brain stimulation (DBS).
Doctor Abraham Zangen discusses how transcranial magnetic stimulation (TMS) can stimulate different areas of the brain and treat depression.
Professor Helen Mayberg discusses evidence that depression may have different subtypes relating to different genes, environments, and neuropathologies.