On-demand Brain Stimulation Treats Treatment-Resistant Depression

Major depressive disorders have been known to be a difficult condition to cure, and many efforts have been made to treat these psychiatric disorders efficiently, even those that may seem chronic throughout the patient’s life. Deep brain stimulation is one of these treatments that have been identified to offer support to patients with depression, especially those that could not witness significant results from other treatments, by disrupting brain circuits with electrodes.

In the October 4th issue of Nature Medicine, a study with on-demand brain stimulation as a treatment for severe depression showed that a woman named Sarah benefited from the stimulation and displayed milder symptoms of depression. Although she did not react to any other treatments, deep brain stimulation appeared to help, as the stimulation device was adapted to fit her needs. Subsequently, in order to develop this device, scientists faced many challenges.

Referencing off of past studies on brain stimulation, Andrew Krystal, MD, MS, Edward Chang, MD, Katherine Scangos, MD, PhD, and colleagues discovered that specialized devices could only be created if a neural biomarker—a specific pattern of brain activity that indicates the start of the symptoms—was identified in Sarah. Unlike the traditional brain stimulation device that could only identify patterns in one area of the brain, the customizable on-demand brain stimulation device can differentiate between patterns and only activate once they are found. It would then repeat for other areas of the brain circuit and have on-demand treatment for the patient’s cause of the disorder: their brain and their neural circuit.

The results were astounding. The study began with Sarah with a score of 36/54 on the Montgomery-Asberg Depression Rating Scale—how severe depressive episodes are—and proceeded to drop down to 14 and 10 out of 54 within the first few months of the treatment. The lowest score also remained at its level for more than a year, signifying that Sarah was free from the stress of major depressive episodes. To this, Sarah commented that “the lessening of the depression was so abrupt, and [she] wasn’t sure if it would last…but it has lasted”.

Nevertheless, Sarah is just one individual, the first of many patients that are needed to prove this study to be accurate. FDA approval would also be necessary to pass on-demand brain-stimulation as a tested method of treating major depressive disorders, but this study conducted by Krystal, Chang, and Scangos would guide them towards even more possibilities of treatment.


Categories: Clinical