Comments on: Deep Brain Stimulation – A New Frontier in Psychiatry

By: Antonio J R M

Antonio J R M — Thu, 10 Jun 2010 10:54:02 +0000

We believe it is a delicate practiced. Even little is known the ranks of mV, nanoamper and Hz of neurons and synapses for network efficient or there is a patron investigated in human living and healthy.

By: Tools For Healing

Tools For Healing — Wed, 31 Mar 2010 07:16:23 +0000

DBS may be useful however is it accessible to the general public when they most need it? If not then it certainly has its limitations. Another form of effective brain stimulation is adio visual stimulation AVS which is a type of brainwave entrainment (see link) – you can have sound with the option of light. This is an effective method of stimulating the brain and can help whoever uses it to enter into different states of consciousness. I know for example that people who have depression and ADD may have difficulty producing beta waves which are associated with alertness – there brains tend to be more in the theta alpha range with minimal beta. Therefore their inability to remain focused and their brains possibly chemical imbalance leading to the depression. Entrainment soundtrackes are easy to use and accessible to all. All you have to do is listen once or twice a day and you will begin to see results fast.

By: Shaheen E Lakhan, MS, MEd, PhD, MD

Shaheen E Lakhan, MS, MEd, PhD, MD — Thu, 25 Mar 2010 20:35:59 +0000

Dear Dirk,Those are excellent questions; the first two are actually somewhat addressed in our article:

Knowledge of specific pathways involved in OCD and TRD is obviously critical to further advances in the uses of DBS for psychiatric disorders. Tractography, also known as diffusion tensor imaging, is a relatively new procedure for determining functional connections between brain locations in living humans. Although the mathematics involved is complex, the MRI is simply used to measure the movement of oxygen along pathways from a "seed" voxel to areas that receive signals from the seed. A good discussion on it has been made by Taylor [43].More germane to the DBS discussion, Gutman [3] has used tractographic analysis to examine the connections from seeds in the cingulate gyrus (CG) to the AL/IC. These are the two areas for DBS that are featured prominently in Table 1. They found that CG connected to the medial frontal cortex, anterior and posterior cingulate, medial temporal lobe, medial thalamus, hypothalamus, nucleus accumbens and dorsal brain stem. AL/IC projected to frontal pole, median temporal lobe, cerebellum, nucleus accumbens, thalamus, hypothalamus, and brainstem. While the two seeds were connected to some common areas, those connections seemed to be via different white matter bundles. Gutman suggested the two locations exist within separate neural networks that include common nodes. Larger studies, including both control subjects and patients, are needed for further clarification but until in vivo tract tracing in human is possible, results cannot be fully verified.

On the latter question on trying to find correlations with serotonin/dopamine (or any of the neurotransmitter) models, in my opinion, it would be very premature to link the effects of DBS for depression with a molecular model . Therefore, I would rather defer my answer on this issue until some other key studies are published. Stay tuned...Thank you.Sincerely, Shaheen

By: Dirk Hanson

Dirk Hanson — Thu, 25 Mar 2010 20:13:43 +0000

Specifically, do we know why electrical stimulation of these two brain areas produces an effect on depression for some people? What is your theory on why this works? How do these findings connect with serotonin/dopamine models of depressive illness?

By: Deep Brain Stimulation – A New Frontier in Psychiatry | :National News NC Mental Hope

Sat, 13 Mar 2010 11:51:57 +0000

[...] Story continues here ? [...]

By: Shaheen E Lakhan, MS, MEd, PhD, MD

Shaheen E Lakhan, MS, MEd, PhD, MD — Fri, 12 Mar 2010 19:19:09 +0000

Dear Dan,There is certainly much clinical interest in this field. ClinicalTrials.gov reports at least 20 studies on DBS for depression. However, many are primarily for movement disorders with additional investigation into concomitant mood/cognitive disorders, some are not recruiting/inactive, others are complete and the results have been included in my article, and most of the remaining trials are recruiting by invitation only. The key is now identifying the optimal areas for stimulation with more pilot studies and then pursuing larger clinical trials. Thank you.Sincerely, Shaheen

By: Dan

Dan — Fri, 12 Mar 2010 17:34:21 +0000

I recently commented on a sciencedaily.com article reporting success with TRD and deep brain stimulation. You touch on many issues, not the least important being access. If these procedures prove to be effective, then who decides who get’s them? I know in the states, without the single payer option, insurance companies regulate which procedures are covered and I’m not sure what they allow regarding DBS. In other countries, who decides? None the less, the work looks interesting and promising.

Is there the chance that there will be wider trials for TRD and DBS?