Wariness on Surgery of the Mind

A very balanced and thoughtful article written by Benedict Carey in the NYTimes on a paper which appeared in the February issue of Health Affairs. This paper makes some ethical arguments regarding the use of the Humanitarian Device Exemption for DBS in Obsessive-Compulsive Disorder.

Brain implants have long-lasting effect on depression

Allison Abbott writes in naturenews on long-term outcomes of cg25 DBS for Major Depression, read it here.

Cross-species affective functions of the medial forebrain bundle—Implications for the treatment of affective pain and depression in humans

A paper which appeared in Neuroscience & Biobehavioral Reviews reports data showing that all currently researched DBS targets for depression - which all lead to comparable response rates in patient populations with comparable treatment refractoriness - actually stimulate in close proximity to the medial forebrain bundle (MFB) pointing to the possibility that this structure might be involved in mediating antidepressant effects. Full reference below.

Volker A. Coenen, Thomas E. Schlaepfer, Burkhard Maedler, Jaak Panksepp. Cross-species affective functions of the medial forebrain bundle—Implications for the treatment of affective pain and depression in humans. Neuroscience & Biobehavioral Reviews, 2010; DOI: 10.1016/j.neubiorev.2010.12.009

Brain Pacemakers: A Long-Lasting Solution in the Fight Against Depression?

A report on a putative new DBS target - the medial forebrain bundle - for depression, read it here. It refers to a recent paper in Neuroscience & Biobehavioral Reviews titled Cross-species affective functions of the medial forebrain bundle—Implications for the treatment of affective pain and depression in humans.

Deep brain stimulation surgery 'first' for depression

This is a press release on a program which was broadcasted by the BBC January 24, 2011. They (the journalists) claim that this is the 'first' use of DBS for depression (I hope that the investigators don't). Read the release and watch the video here.

Vagus Nerve Stimulation (VNS) and Treatment of Depression: To the Brainstem and Beyond

PMID: 21103178

AUTHORS: John P O'Reardon, Pilar Cristancho, Andrew D Peshek

REFERENCE: Psychiatry (Edgmont) 2006 May 3(5):54-63

Neuromodulation appears to be emerging gradually as a new therapeutic
field in psychiatric treatment. It encompasses neuropsychiatric medical
devices, such as vagus nerve stimulation (VNS), transcranial magnetic
stimulation (TMS), deep brain stimulation (DBS), and electroconvulsive
therapy (ECT). As a therapeutic approach to affective disorders,
neuromodulation shifts the focus from the monoamine synapse to neural
circuitry of the brain, which is dysregulated in depression. This neural
circuitry has been elaborated on over the course of 15 years of
neuroimaging research in mood disorders and is now believed to encompass
disturbances in a frontolimbic network. These include reduced
metabolism and blood flow in the prefrontal cortex and anterior
cingulate and pathologically increased activity in the subgenual
cingulate and amygdala.VNS is an implanted device that has established
efficacy in pharmaco-resistant epilepsy. It was approved by the FDA for
the treatment of severe, recurrent unipolar and bipolar depression in
July of 2005. VNS adopts a bottom-up approach to modulating the neural
circuitry of depression by stimulating vagal afferent fibers in the neck
, which carry impulses to the brain stem to target there the locus
ceruleus and dorsal raphe nucleus. Now that VNS has moved beyond the
experimental phase and into the clinic, psychiatrists are faced with
deciding who is an appropriate patient for this surgical implant and how
to integrate VNS into existing treatment in order to optimize both
efficacy and safety.This review of VNS will assess the efficacy and
safety data that led to the FDA approval. We will also review for the
busy clinician how VNS is likely to translate into clinical practice as
a treatment option for patients in need who are suffering from severe
depression.

Modeling of electromagnetic stimulation of the human brain

PMID: 21095888

AUTHORS: Dmitry Lazutkin, Peter Husar

AFFILIATION: Division of Biological Signal Processing, Department of Biomedical Engineering and Medical Informatics, Ilmenau University of Technology, PO Box 100565, 98684, Germany.

REFERENCE: Conf Proc IEEE Eng Med Biol Soc 2010 1():581-4

The World Health Organization estimates depression as a serious threat
to the health of millions of people worldwide. The purpose of this paper
is to introduce the ongoing research devoted to the investigation of a
possibility to use low-field electromagnetic stimulation of the human
brain in the treatment of depressive disorder. In the course of the work
the 3D models of transcranial magnetic stimulation and low-field
magnetic stimulation based upon the use of a layered sphere head model
have been developed. An initial approach towards the realistic human
head reconstruction has been made. The revealed order of the stimulating
electromagnetic field suitable for operation makes it possible to draft
a technical specification for the stimulation device.