As I've hoped and hypothesized, Dr. Mayberg, who is one of the founders of using DBS for depression, has released research under a NIH grant relating to being able to diagnose what treatment method will work best for each individual with depression. i.e. Run the test and it will show whether an SSRI, SSNI, Cognitive Behavior Therapy (CBT) or something more radical like DBS stands the best chance of working. (They haven't refined it that far but the initial research is fantastic).
In the linked article, they correlated activity in the brain called the "anterior insula" with CBT and a SSRI. Based on either low or high activity in the insula, the type of treatment that worked best for the patient has a high correlation. Another article (http://www.medscape.com/viewarticle/806426) gets a little more technical and the actual JAMA article is at http://archpsyc.jamanetwork.com/article.aspx?articleid=1696349.
Pretty cool stuff, if you ask me. Of course this is all very preliminary work but it's a giant step forward.
For those interested in DBS, there are a number of research studies using different locations in the brain. There are links to the side and in the blogs that refer to the actual locations and that the current theories hold that, like many things in the brain, depression is a circuit of sorts. That circuit runs through a number of areas and the current research is showing that there are a number of places that DBS works. Finding the place that works the best or to extend this latest research, using some type of imaging may lead to prescribing a certain anti-depressant, seeing a therapist, or in severe cases, which place in the brain to insert some electricity.Woo hoo.
Saturday, June 29, 2013
Sunday, April 14, 2013
Hope
Hope is one of the hardest things to muster when suffering deep depression. Unfortunately, too many lose that last ember of hope. I'm publishing a couple of really exciting links. I've mentioned before that there are numerous DBS studies around. I usually only hear from those in the US in the St. Jude study.
The first is great news - if the USA can find the money. It confirms what I predicted many blogs back - that the amount of research and technology advancements that we've seen in the last 30 years regarding the heart, will be replaced by research of the brain. (throw in the human genome project as another great step forward). Here is the NY Times link, but HOPEfully everyone suffering from depression understands the potential of 10 years of concentrated study of the brain:
http://www.nytimes.com/2013/02/18/science/project-seeks-to-build-map-of-human-brain.html?pagewanted=all&_r=0
Next up, and the impetus for me to write about it is the research in Germany where they are implanting it yet another area. I won't attempt to explain the different areas being explored but they all seem to be interconnected in a circuit, that when disrupted, provides relief from this Hell called Major Depressive Disorder.
http://neurosciencenews.com/deep-brain-stimulation-medial-forebrain-bundle-success-major-depression-patients/
Another link about the same study: http://www.business-standard.com/article/pti-stories/brain-pacemaker-to-treat-acute-depression-113041000157_1.html
And here is the HOPE... for anyone wishing they could get in a study or find ANY way to rid themselves of this disease, hang on. This is the third "successful" area of the brain that I am aware of to be probed. I personally believe we will discover there are multiple 'depressions' and different treatments will be developed for each. I've seen the inside research on some new TMS that is outstanding (but not yet available at your pharmacy).
Not being a brain surgeon, I'm not sure if this is the same area Bonn was playing with before or not. It sounds like a new area - so there may be 4 areas being studied, plus things like VNS and TMS.
But this is exciting news.
There is good reason to have HOPE.
The first is great news - if the USA can find the money. It confirms what I predicted many blogs back - that the amount of research and technology advancements that we've seen in the last 30 years regarding the heart, will be replaced by research of the brain. (throw in the human genome project as another great step forward). Here is the NY Times link, but HOPEfully everyone suffering from depression understands the potential of 10 years of concentrated study of the brain:
http://www.nytimes.com/2013/02/18/science/project-seeks-to-build-map-of-human-brain.html?pagewanted=all&_r=0
Next up, and the impetus for me to write about it is the research in Germany where they are implanting it yet another area. I won't attempt to explain the different areas being explored but they all seem to be interconnected in a circuit, that when disrupted, provides relief from this Hell called Major Depressive Disorder.
http://neurosciencenews.com/deep-brain-stimulation-medial-forebrain-bundle-success-major-depression-patients/
Another link about the same study: http://www.business-standard.com/article/pti-stories/brain-pacemaker-to-treat-acute-depression-113041000157_1.html
And here is the HOPE... for anyone wishing they could get in a study or find ANY way to rid themselves of this disease, hang on. This is the third "successful" area of the brain that I am aware of to be probed. I personally believe we will discover there are multiple 'depressions' and different treatments will be developed for each. I've seen the inside research on some new TMS that is outstanding (but not yet available at your pharmacy).
Not being a brain surgeon, I'm not sure if this is the same area Bonn was playing with before or not. It sounds like a new area - so there may be 4 areas being studied, plus things like VNS and TMS.
But this is exciting news.
There is good reason to have HOPE.
Saturday, February 9, 2013
Interesting Ethics
A person who contacted me has this link posted on their facebook. Absolutely interesting article. (It is a pay per view research paper but the first 2 pages are worthwhile). This isn't to try and scare anyone away from the procedure but to highlight the fact that the research going on is dealing with some of the worst depression imaginable and there are risks.
As a long time advocate of the research protocol mandating that a person be assigned to a counselor or therapist, I believe Dr. Gilbert has made the point. My opinion, for what it is worth, is that a therapist (who may be blind to whether the person is turned on or not) should check in with patients for the first few weeks after every visit for a "tune-up". And of course, be available whenever the person needs someone to talk with.
As a general statement, we don't like socializing much and definitely don't like talking about how we feel if the gizmo doesn't seem to be working. But ethically, I would think the IRBs should require it. (And not just for us depressed, but probably for all experimental DBS).
As for me..... nothing really new to report. What I've discovered in myself though is much less interest in following the subject. It's almost like a denial reflex that I should stay abreast of all the research on DBS. Not reading about it makes it not real for me, so to speak. I'm overall pleased with the continuing research into TRD and depression in general. Some of the outcomes of the latest TMS are FASCINATING to say the least, but I find myself less "glued" to the Internet over depression. Denial is a wonderful thing.
Best to all. Wish NM would contact me.
As a long time advocate of the research protocol mandating that a person be assigned to a counselor or therapist, I believe Dr. Gilbert has made the point. My opinion, for what it is worth, is that a therapist (who may be blind to whether the person is turned on or not) should check in with patients for the first few weeks after every visit for a "tune-up". And of course, be available whenever the person needs someone to talk with.
As a general statement, we don't like socializing much and definitely don't like talking about how we feel if the gizmo doesn't seem to be working. But ethically, I would think the IRBs should require it. (And not just for us depressed, but probably for all experimental DBS).
As for me..... nothing really new to report. What I've discovered in myself though is much less interest in following the subject. It's almost like a denial reflex that I should stay abreast of all the research on DBS. Not reading about it makes it not real for me, so to speak. I'm overall pleased with the continuing research into TRD and depression in general. Some of the outcomes of the latest TMS are FASCINATING to say the least, but I find myself less "glued" to the Internet over depression. Denial is a wonderful thing.
Best to all. Wish NM would contact me.