Deep brain stimulation for depression
Deep brain stimulation for depression
Deep brain stimulation involves implanting electrodes within the part of your brain that affects mood. During deep brain stimulation, electrical impulses transmitted through the electrodes deep within the brain affect brain cells and chemicals to relieve depression. The amount of stimulation delivered by the electrodes is controlled by a pacemaker-like device placed under the skin in your upper chest. A wire that travels under your skin connects the device, called a pulse generator, to the electrodes in your brain.
Although it's approved for other conditions, deep brain stimulation for depression hasn't been approved by the Food and Drug Administration (FDA). It's still being studied as an experimental treatment. Most candidates for deep brain stimulation are participants in clinical trials.
Why it's done
Deep brain stimulation is an established treatment for essential tremor and Parkinson's disease. Some people with Parkinson's who underwent deep brain stimulation reported an improved mood. Because of those results, deep brain stimulation is being studied as a possible depression treatment to be used when standard treatments don't work. Standard treatments include antidepressants, psychological counseling (psychotherapy) and electroconvulsive therapy (ECT).
Sending electrical impulses to areas of the brain linked with mood affects brain cells and brain chemistry. While this can help ease depression symptoms, researchers are still investigating exactly how deep brain stimulation improves mood.
Deep brain stimulation also shows some promise for some other mental illnesses. It has been approved by the Food and Drug Administration (FDA) as a treatment for severe and debilitating obsessive compulsive disorder (OCD). It's also being investigated to see whether it may help with Tourette syndrome, chronic pain and other disorders.
Although initial results are promising, more research is needed to determine whether deep brain stimulation can be considered a safe and effective treatment for depression. Researchers are still trying to identify the best locations for the electrode implants to help reduce symptoms while causing the least side effects.
Although deep brain stimulation is generally safe, any type of surgery carries risks and complications can occur. Also, the brain stimulation itself may cause side effects.
With deep brain stimulation, surgery is not a one-time procedure. Pulse generator batteries have a limited life span and when they run out, symptoms of depression may quickly return. Replacing the dead battery requires surgery to access the pulse generator. Batteries last from six to 18 months. It's also possible for a wire connecting the pulse generator to an electrode to break or for other malfunctions to occur.
Possible side effects after surgery
How you prepare
Because deep brain stimulation is experimental, it's available only through participation in clinical trials. Because of the risks involved, its use is limited to people who have severe, debilitating depression that hasn't improved with standard treatments. The procedure requires an experienced surgical team.
First, weigh the pros and cons
Next, preparing for surgery
What you can expect
During the surgery
After the procedure
Stimulation is generally constant, 24 hours a day. The pulse generator can be easily programmed from outside your body with a hand-held magnetic device you're given to use. With this, you can temporarily turn off stimulation by holding the magnet over the area of your chest where the pulse generator is implanted. When you move the magnet away, stimulation restarts.
You must remain in close contact with your surgeon or other specialist involved, to make sure that the pulse generator is working correctly. You may also need to continue standard depression treatments, such as taking antidepressants.
Deep brain stimulation
Deep brain stimulation involves implanting an electrode deep within your brain. The amount of stimulation delivered by the electrode is controlled by a pacemaker-like device placed under the ...
If deep brain stimulation works, your depression symptoms will improve or go away completely. It may take several months of treatment with deep brain stimulation before you notice improvements in your depression symptoms. Not everyone with chronic depression, especially those who have had depression for years, gets better with deep brain stimulation.
Last Updated: 2010-07-29
© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
Terms and conditions of use