Zapping ‘mystery region’ of the brain relieves depression symptoms study suggests
- Almost half of all depression patients have treatment resistant forms of it
- Research has suggested that electrical stimulation may help ‘reset abnormal neural activity in depressed brains
- Scientists have struggled to find a relatively non-invasive target that yields consistent results
- Now, University of California, San Francisco researchers may have found it
- Electrically stimulating the orbitofrontal cortex alleviated depression almost instantly in small study of epilepsy patients
Zapping parts of the brain with electricity could beat the blues, a new study suggests.
Researchers at the University of California, San Francisco (UCSF), say they have found an ‘effective target’ in the brain for electrical stimulation to improve the mood of people suffering from depression.
Their findings, published in the journal Current Biology, show stimulation of a brain region called the lateral orbitofrontal cortex (OFC) reliably produced ‘acute’ improvements.
The study was small – involving just 25 patients – but its results were promising, and may point scientists toward a new and improved target for treating even the most difficult cases of depression.
Delivering electrical impulses to the poorly-understood OFC region of the brain consistently helped depressed epilepsy patients within just three minutes in a new small study (file image)
Nearly half of depression patients (an estimated 45 percent) have treatment resistant forms of the mood disorder.
Talk, behavioral and drug therapies all fail these patients, leaving them at dramatically increased risks of suicide.
Doctors are trying to develop alternative therapies to provide those with treatment resistant depression some relief, experimenting with everything from electroshock therapy to ketamine, psychedelic drugs and, of course, brain stimulation.
The brain’s regions communicate with one another through electrical impulses that form connections between these brain areas.
In depressed brains, there is often too much activity in some areas of the brain or too little in others.
Deep brain stimulation is sometimes used to help treat some forms of Parkinson’s disease, but trials fr depression have yielded mixed results.
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Most areas that scientists have tried ‘zapping’ with the rather invasive procedure have not provided consistent benefits. The few that have shown more solid signs of working have been tested in small trials with slightly shaky methodology.
Though it’s still small, the new UCSCF study mad the more superficial OFC brain region look like a better safer target. Patients’ symptoms improved almost instantly when their brains were zapped.
The effects were not seen in patients without mood symptoms, which the researchers say suggests that the brain stimulation works to normalize erratic activity in mood-related neural circuitry.
Dr Kristin Sellers, a postdoc researcher at UCSF said: ‘Patients said things like ‘Wow, I feel better,’ ‘I feel less anxious,’ ‘I feel calm, cool and collected’.
‘And just anecdotally, you could see the improvements in patients’ body language. They smiled, they sat up straighter, they started to speak more quickly and naturally.’
She added: ‘Although OFC is a more superficial target, it shares rich interconnections with several brain regions implicated in emotion processing.’
Dr Sellers said that made the relatively small brain area an attractive target for therapeutic stimulation.
A team led by Dr Sellers and Dr Vikram Rao in the lab of Professor Edward Chang studied 25 patients with epilepsy who had electrodes placed in the brain for medical reasons to pinpoint the origin of their seizures.
Many of the patients also suffered from depression, which is often seen in people with epilepsy.
With the patients’ consent, Prof Chang’s team took advantage of the electrodes to deliver small electrical pulses to areas of the brain thought to be involved in regulating mood.
Dr Rao said: ‘Stimulation induced a pattern of activity in brain regions connected to OFC that was similar to patterns seen when patients naturally experienced positive mood states.
‘Our findings suggest that OFC is a promising new stimulation target for treatment of mood disorders.’
Previous studies have explored deep brain stimulation (DBS) for mood disorders, but its success depends critically on target selection.
Targets in other mood-related areas deep in the brain hadn’t always led to reliable improvements.
For the new study, the researchers focused their attention and the electrical stimulation on the OFC, which is a key hub for mood-related circuitry.
But the region also widely regarded as a bit of a mystery compared to other parts of the brain.
The researchers used the implanted electrodes to stimulate OFC and other brain regions while collecting verbal mood reports and questionnaire scores.
The changes in brain activity the researchers observed after stimulation closely resembled those seen when people are in a good mood.
Prof Chang said: ‘The OFC has been called one of the least understood regions in the brain, but it is richly connected to various brain structures linked to mood, depression and decision making, making it very well positioned to coordinate activity between emotion and cognition.’
The researchers say their findings show that mood can be immediately improved by electrical stimulation of a relatively small area of brain. and also add to evidence that mood disorders are the result of dysfunction in brain circuits.
But they said that plenty of work remains before DBS could enter routine clinical practice.
Dr Rao said: ‘Ultimately, it would be ideal if activity in mood-related brain circuits could be normalised indefinitely without patients needing to do anything.’
Dr Heather Dawes, who helped to oversee the research, added: ‘The more we understand about depression at this level of brain circuitry, the more options we may have for offering patients effective treatments with a low risk of side effects.
‘Perhaps by understanding how these emotion circuits go wrong in the first place, we can even one day help the brain ‘unlearn’ depression.
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