Researches Show Efficacy Of Personalized Brain Stimulation In Psychiatric Treatments
MARY LOUISE KELLY, HOST:
Two studies out today suggest ways to improve treatments for depression and obsessive-compulsive behavior using brain stimulation. The approach delivers pulses of electric or magnetic energy to certain areas in the brain. Scientists report that stimulation is more effective when it is customized for each patient. NPR's Jon Hamilton has more.
JON HAMILTON, BYLINE: Brain stimulation is usually reserved for people who haven't been helped by drugs or other treatments - people like this woman in her 30s who had severe, unrelenting depression.
UNIDENTIFIED PERSON: The world was slow and gray and flat. Everything kind of tasted the same - no actual sense of enjoyment or no ability to imagine.
HAMILTON: NPR agreed not to use the woman's name to protect her medical privacy. After five years of searching for help, she got into a study run by Dr. Katherine Scangos at the University of California, San Francisco. Scangos is part of a team trying to improve deep brain stimulation, which implants wires in the brain to deliver tiny pulses of electricity.
KATHERINE SCANGOS: Traditional deep brain stimulation has typically stimulated in one location in every patient without really an understanding of how that affects each individual's depression symptoms.
HAMILTON: Scangos thought she might be able to relieve the woman's depression using a different approach. So she created a map of her patient's brain that showed which area was associated with each symptom.
SCANGOS: She had an iPad, and she marked off her level of depression and anxiety and energy level in response to each pulse of neuromodulation.
HAMILTON: Then Scangos used that information to design a deep brain stimulation system that monitored these areas and delivered pulses only when there were signs of trouble.
SCANGOS: Our goal is to develop a brain pacemaker that can nudge these depression circuits back into their healthy state and keep them there.
HAMILTON: And for this patient, it worked. She recalls the first time doctors stimulated one particular area of her brain.
UNIDENTIFIED PERSON: I wasn't really expecting anything to happen. And then suddenly, there was this kind of woosh of this sense of pleasurable happiness and glee, and I literally think I giggled.
HAMILTON: She says the implanted stimulator she went home with is still doing its job months later.
UNIDENTIFIED PERSON: The world is back. I'm back. I feel like myself again.
HAMILTON: A personalized approach to brain stimulation also seemed to help people with obsessive-compulsive behaviors. Trey Grover (ph), a graduate student at Boston University, was part of a team that studied people who had thoughts that wouldn't go away or behaviors that they felt compelled to repeat.
TREY GROVER: Checking whether we've switched the stove off or not. Have we washed our hands enough? And particularly in times like ours today, (unintelligible) such behaviors can be exacerbated.
HAMILTON: The team knew that these kinds of behaviors are linked to problems in the brain's reward network. So they studied the activity in this network for about 60 patients. Then they devised a unique stimulation treatment for each person. Grover says the treatment sends pulses of alternating current through electrodes placed on the scalp.
GROVER: It allows us to stimulate the brain and mimic the kinds of rhythmic activity patterns that are typically associated with healthy behavior.
HAMILTON: He says people who got the treatment instead of a placebo got better.
GROVER: By the fifth day of stimulation, obsessive-compulsive behaviors had significantly reduced. On average, there was a 28% reduction.
HAMILTON: And Grover says the treatment worked best on people with the most severe symptoms. Both studies appear in the journal Nature Medicine.
Jon Hamilton, NPR News.
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