Updated: Oct 22, 2021
SAN FRANSISCO, CA — A 36-year-old named Sarah is the first patient in the world to undergo an experimental treatment for major depression via a customized brain implant. The researchers behind the work, Katherine Scangos and Andrew Krystal from the University of California at San Francisco, call it the most remarkable experience of their psychiatric careers. They now hope to replicate the treatment with other patients and possibly pave a road toward customizable, effective depression therapy for those who haven’t gotten relief from any other treatment.
The way the treatment works is researchers mapped out Sarah’s brain circuitry in order to identify biological markers that told them symptoms were coming. They then implanted a device that delivered targeted electrical stimulation to key areas once those biological markers were detected. In Sarah’s case, what they found was her amygdala, the brain region in charge of emotional processing, was a reliable center of depressive activity, sending up more than eighteen biological flares per hour. By sending a stimulation to a spot deep in Sarah’s brain any time it was triggered by those biological markers, the amygdala’s overreaction could be soothed.
The implant the UCSF team used, called a NeuroPace device, was granted an investigational exemption by the Food and Drug Administration, but it hasn’t been cleared for more general use in treating depression, and the mechanism by which it is working to relieve Sarah’s depression is not entirely clear.
Edward Chang, the senior author of the study, first identified the possibility of using brain stimulation for depression years ago, as he was treating epileptic patients with electrical stimulation and noticed a difference in their moods, anxiety, and depressive symptoms.
Unlike deep brain stimulation treatments that send a constant flow of electricity into the brains of patients with epilepsy and Parkinson’s disease, the treatment used on Sarah involves stimulations lasting only six seconds whenever a specific depressive biomarker is identified.
Researchers don’t know how long Sarah will need to have the device in her skull, or if depression circuitry in the brain changes over time. But they can program the device to respond to various inputs, and at the rate of treatment Sarah receives, the device battery should last for about a decade.
In recent months, UCSF researchers have been studying two additional patients, a man and a woman in their 30s, and finding results consistent with what they saw in Sarah. The team plans to recruit nine more patients for the clinical trial.
Gregory Grinberg, managing partner at Gale, Sutow & Associates, shared some thoughts on his blog regarding the potential implications of this in workers’ compensation. You can read his take here: