Monday, April 03, 2006

A Depression Switch?

This is amazing. The New York Times has an article in the Sunday Magazine about a spot in the brain that if stimulated alleviates depression.
The operation borrowed a procedure called deep brain stimulation, or D.B.S., which is used to treat Parkinson's. It involves planting electrodes in a region near the center of the brain called Area 25 and sending in a steady stream of low voltage from a pacemaker in the chest. One of the study's leaders, Dr. Helen Mayberg, a neurologist, had detected in depressed patients what she suspected was a crucial dysfunction in Area 25's activity. She hypothesized that the electrodes might modulate the area and ease the depression. …

The D.B.S. operation involves an intrusion that is delicate but brutal. The patients are kept awake so they can describe any changes, and the only drug administered is a local anesthetic. …

Mayberg had squeezed into a spot at Deanna's [the patient] side some time before. She had told Deanna that if anything felt different, she should say so. Mayberg wasn't going to tell her when the device was activated. "Don't try to decide what's important," Mayberg told her. "If your nose itches, I want to know." Now and then the two would chat. But so far Deanna hadn't said much.

'So we turn it on,' Mayberg told me later, 'and all of a sudden she says to me, 'It's very strange,' she says, 'I know you've been with me in the operating room this whole time. I know you care about me. But it's not that. I don't know what you just did. But I'm looking at you, and it's like I just feel suddenly more connected to you.'

Mayberg, stunned, signaled with her hand to the others, out of Deanna's view, to turn the stimulator off. 'And they turn it off,' Mayberg said, 'and she goes: 'God, it's just so odd. You just went away again. I guess it wasn't really anything.'

'It was subtle like a brick,' Mayberg told me. 'There's no reason for her to say that. Zero. And all through those tapes I have of her, every time she's in the clinic beforehand, she always talks about this disconnect, this closeness and sense of affiliation she misses, that was so agonizingly painful for her to lose. And there it was. It was back in an instant.' …

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