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Stimulation Device Offers Relief from Hard-to-Treat Depression

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Although great strides have been made in treating depression, those who suffer from treatment-resistant depression have continued to present a serious challenge to doctors seeking a way to help them.

Researchers at Medical University of South Carolina in Charleston recently broke new ground by using a revolutionary technique that holds promise for the severely depressed: bilateral epidural prefrontal cortical stimulation, a neurosurgical treatment.

The procedure is a form of brain surgery. It consists of implanting four paddles that deliver chronic and intermittent electrical stimulation to the surface of the part of the brain governing mood and socialization. The device that's inserted is similar to a pacemaker and has already been used to stimulate the spine as a means of combating pain.

"We're focusing on a very small but fairly disabled group of depressed patients," explained Dr. Ziad Nahas, who spearheaded the study and recently published the results in the journal Biological Psychiatry. Dr. Nahas has been studying brain stimulation and the pathophysiology of depression using brain imaging for over a decade. He has close to one hundred scientific publications and is the director of the Mood Disorders Program at the university. "These patients have typically failed many treatments and have suffered recurrent and severe depression for decades. Because of the experimental nature of our approach, they had to meet many criteria [to be part of the study] -- primarily, that there didn't seem to be another option for them.

"For an antidepressant treatment to work, it should not only improve depressive symptoms but also allow the patients to disengage from their attention to negative emotions and appraise their world with a wider range of experiences," Nahas continued. "I hypothesized five years ago that if we could deliver direct and chronic stimulation over areas of the brain that are involved in regulating mood and social behavior, we might be able to treat depression and sustain the improvement much longer than we typically see with current available therapies.

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