There was no cure for her depression-but this time, a miracle happened

Sarah has tried almost every method in the world to treat depression.

this includes about 20 different drugs, transcranial magnetic stimulation, and electroconvulsive therapy-but unfortunately, none of them works. Sarah is still suffering from severe depression and suicidal impulses occur several times an hour. Forcing herself to fight these thoughts is enough to wear her out, and she can hardly do anything else.

and at this point, a clinical trial changed her fate.

the experimental treatment showed amazing results: Sarah's suicidal thoughts disappeared in just a few weeks. Now, more than a year later, Sarah's symptoms have almost disappeared. She can not only move out to live on her own, take care of her mother who was injured when she fell, but also started taking data analysis courses. Even under the pressure of the epidemic, she did not fall into depression again.

how do miracles happen? All thanks to the treatment plan tailored to her by the researchers, as well as a matchbox-sized implant device [1].

(Sarah is the first subject in this clinical trial (the patient did not disclose her full name)

customized treatment

the therapy that successfully relieves Sarah's depressive symptoms is called "deep brain stimulation"-in short, electrical stimulation is given to designated brain areas to restore neural activity to normal.

similar treatments have been successful in the field of epilepsy and Parkinson's disease, but the situation of depression is more complicated. Before implementing the treatment, the researchers must first determine two things: what indicators should be tested to know when Sarah's symptoms will occur? And where do you need to stimulate to stop these symptoms?

to get the answer, researchers from the University of California, San Francisco first implanted 10 electrodes in different areas of Sarah's brain. On the one hand, they monitor EEG signals through electrodes to look for characteristics associated with mood changes. On the other hand, the researchers tested electrical stimulation in different brain regions of Sarah and recorded her response.

(to customize the treatment plan, the researchers first implanted 10 electrodes in both sides of Sarah's brain for stereotactic EEG monitoring. Katherine W. Scangos et al.)

the experiment found that the γ wave characteristics of Sarah's amygdala can reflect the severity of her depressive symptoms while stimulating another area of her right brain (ventral internal capsule /ventral striatum) can effectively relieve the symptoms.

Electrical stimulation had an immediate effect. "when I was stimulated for the first time, I felt intense happiness, and my depression temporarily turned into a distant nightmare," Sarah said in an interview. The miraculous change of mood made her laugh-- she had never laughed so sincerely in the five years before. She looked down at her needlework, which had been done only to drive suicidal thoughts out of her mind, but now she was having fun with it.

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(Sarah JOHN LOK/UCSF walking the dog)

implant a "brain pacemaker"

of course, one electrical stimulation is not enough, the next task is to give the implant device that can carry out the long-term treatment.

Sarah underwent a second operation, and this time the researchers implanted her with a device the size of a matchbox. The device is compared to a "brain pacemaker" that detects EEG features according to preset settings and releases electrical stimuli as required. It has been approved by the FDA as an epileptic treatment device, and this is the first time it has been used to treat depression.

(the "brain pacemaker" implanted by the researchers for Sarah | Katherine W. Scangos et al.)

in August 2020, Sarah's customized "brain pacemaker" officially began to work. Whenever abnormal gamma waves in the amygdala are detected, the device is treated with electrical stimulation for six seconds in the right brain region mentioned above. Twelve days after the device was activated, Sarah's Montgomery Depression scale score dropped from 33 to 14, and a few months later dropped below 10-suggesting that her condition had been fully relieved.

(researchers examine implanted devices | JOHN LOK/UCSF)

at present, this is only an isolated case, and we do not know whether similar methods can be extended to other patients. However, Sarah's success story does bring new hope for the treatment of severe depression. Next, the researchers plan to expand the sample to 12 people to continue to verify the effectiveness and safety of the treatment.

Sarah's depression didn't go away completely, but everything became easy to control: those thoughts still occur now, but with a bump, the cycle stops.