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Long-lasting effectiveness: deep brain stimulation relieves severe depression
Depression has long been a common disease worldwide. In Germany alone, around six million people are affected within one year, according to health experts. The disease is usually treated with medication and psychotherapy. In the future, deep brain stimulation could also be a treatment option, researchers report.
The number of people with depression is increasing
According to a recent study by the World Health Organization (WHO), the number of people with depression has increased significantly in recent years. Affected people usually suffer from persistent depressed mood, listlessness, anxiety or sleep disorders. Depression is traditionally treated with medication (antidepressants) and psychotherapy. However, this often has no effect on the seriously ill. German scientists are now reporting on a new treatment option.
Relieve or correct symptoms over several years
Deep brain stimulation can alleviate or even resolve the symptoms of patients with previously untreatable, severe forms of depression for several years. Researchers at the Freiburg University Hospital have now shown this in a long-term study of this type of therapy.
According to a statement from the university hospital, seven of the eight patients treated with continuous stimulation continued to improve symptoms after four years up to the observation point after four years.
The therapy therefore remained equally effective over the entire period. Slight side effects that occur can be avoided by adjusting the stimulation. The study results were published in the journal "Brain Stimulation".
“The majority of the patients respond to the therapy. It is unique that they do this permanently, ”said study leader Prof. Dr. Thomas Schläpfer, Head of the Department for Interventional Biological Psychiatry at the Clinic for Psychiatry and Psychotherapy at the University Medical Center Freiburg.
“Other forms of therapy often lose their effectiveness over time. This makes deep brain stimulation a promising approach for people with previously untreatable depression, ”said the expert.
Deep brain stimulation is a procedure based on light electrical stimuli that can be used to influence precisely selected areas of the brain.
Effect in patients with severe depression
According to the researchers, the eight subjects between the ages of three and eleven suffered from severe depression throughout which neither medicinal or psychotherapeutic treatments nor stimulation methods such as electro-seizure therapy improved.
The doctors implanted wafer-thin electrodes and stimulated an area of the brain that is involved in the perception of joy and is therefore important for motivation and quality of life.
The doctors evaluated the effect of the therapy monthly using the established Montgomery-Asberg Rating Scale (MARDS). As the "Ärzte Zeitung" explains, this questionnaire for the external assessment of the severity of a depressive syndrome consists of ten questions with which the symptoms of the past week are assessed.
It was found that the MARDS value already fell on average from 30 points to twelve points in the first month and even decreased slightly further by the end of the study. Four people fell below the MARDS value of ten points from which depression was diagnosed.
An effective treatment option in a few years
Some patients suffered briefly from blurred vision or double vision. "We were able to remedy the side effects by reducing the strength of the stimulation without the antidepressant effect of the therapy having diminished," says Prof. Volker A. Coenen, head of the Stereotactic and Functional Neurosurgery department at the Clinic for Neurosurgery at the Freiburg University Hospital.
No changes in personality, thinking disorders or other side effects were observed in any patient.
If the effectiveness and safety of the therapy is confirmed in a further five-year study with 50 patients currently underway at the University Hospital Freiburg, Prof. Coenen sees the possibility of a European registration of the therapy procedure.
This allows the therapy to be used outside of studies: "For patients with the most severe depression, such deep brain stimulation could be an effective treatment option in a few years," said Prof. Coenen. (ad)