Deep brain stimulation shows promising results for unipolar and bipolar depression

A new study shows that deep brain stimulation (DBS) is a safe and effective intervention for treatment-resistant depression in patients with either unipolar major depressive disorder (MDD) or bipolar ll disorder (BP). The study was published Online First by Archives of General Psychiatry.

The study was led by Helen S. Mayberg, MD, professor in the Departments of Psychiatry and Behavioral Sciences and Neurology at Emory University School of Medicine, with co-investigators Paul E. Holtzheimer, MD, lead psychiatrist and now associate professor and director of the Mood Disorders Service, Dartmouth Medical School, and neurosurgeon Robert E. Gross, MD, PhD, associate professor in the Departments of Neurosurgery and Neurology at Emory. Gross served as chief neurosurgeon for the study.

"Depression is a serious and debilitating medical illness," says Mayberg. "When we found that the potential for effective and sustained antidepressant response with DBS for patients with otherwise treatment resistant major depressive disorder was high, the next step was to determine if patients with intractable bipolar depression could also be successfully treated."

An earlier study by Mayberg done in Toronto in collaboration with scientists at Toronto Western Hospital, University Health Network and Emory, was the first to show such results for patients with treatment-resistant major . Mayberg conducted this new expanded trial at Emory to include patients with bipolar ll disorder.

Bipolar spectrum disorder, sometimes referred to as manic-depression, is characterized by bouts of mania or hypomania alternating between episodes of depression. Although people with bipolar ll disorder do not have full , are frequent and intense, and there is a high risk of suicide. A major challenge in treating bipolar depression is that many antidepressant medications may cause patients to "switch" into a hypomanic or manic episode.

DBS uses high-frequency electrical stimulation targeted to a predefined area of the brain specific to the particular neuropsychiatric disorder. Here, each study participant was implanted with two thin wire electrodes, one on each side of the brain. The other end of each wire was connected under the skin of the patient's neck to a pulse generator implanted in the chest – similar to a pacemaker – that directs the electrical current.

Study participants received single-blind stimulation for four weeks (patients did not know if the DBS system was on or off), followed by active stimulation for 24 weeks. Patients were evaluated for up to two years following onset of active stimulation. Seventeen patients were enrolled in the study.

A significant decrease in depression and increase in function were associated with continuing stimulation. Remission and response rates were 18 percent and 41 percent after 24 weeks; 36 percent and 36 percent after one year and 58 percent and 92 percent after two years of active stimulation. Patients who achieved remission did not experience a spontaneous relapse. Efficacy was similar for and Bi-Polar patients, and no participant experienced a manic or hypomanic episode.

Mayberg and her colleagues continue to refine this intervention. Current studies include demographic, clinical and imaging predictors of response and remission, and introduction of psychotherapeutic rehabilitation. Why and how this treatment works is the primary focus of ongoing research.

"Most of these patients have been in a depressed state for many years and are disabled and isolated," says Holtzheimer. "As their depression improves, they need a process to help them achieve full recovery that includes integration back into society.

"We hope to optimize the rate of improvement for these by using a model of care that provides psychotherapeutic rehabilitation built on evidence-based psychotherapy but tailored to the specific individual's situation."

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Skepticus_Rex
1.2 / 5 (19) Jan 02, 2012
Hmmm. So that old-time 'shock therapy' concept of so many decades ago may actually have had something to it after all. Interesting. :)

But, do we really want them reintegrated into society? While a humanitarian gesture, it also risks increased rates of breeding with the unaffected population, which will introduce more of this sort of element into society. Can society afford the costs?
FrankHerbert
3.6 / 5 (25) Jan 02, 2012
HAHA, why am I not shocked that a troglodyte global warming denier is also a eugenicist?
Skepticus_Rex
1.3 / 5 (14) Jan 02, 2012
For the record, I do not deny that the globe has been warming since the LIA. It has been. However, the question as to any anthropogenic component to this warming (does not account for pre-1950 warming at all and questionable thereafter at best) is where I remain skeptical.

Nor am I a Eugenicist. I am, however, a realist. The real trouble will, however, begin when the number of people suffering with this condition fill the general population with the same genes that cause such suffering before we find a cure for the problems. Their current situation lessens their impact on the overall gene pool. That is a fact.

That said, if you want to talk a real Eugenicist, you will need to talk to VendiTard. He is right up your alley, if you catch my drift (wink, wink...nudge, nudge). :)
FrankHerbert
3.6 / 5 (18) Jan 02, 2012
the study of or belief in the possibility of improving the qualities of the human species or a human population, especially by such means as discouraging reproduction by persons having genetic defects or presumed to have inheritable undesirable traits (negative eugenics) or encouraging reproduction by persons presumed to have inheritable desirable traits (positive eugenics).

dictionary.com

a science that deals with the improvement (as by control of human mating) of hereditary qualities of a race or breed

Merriam-Webster

So are you not a eugenicist or do you not understand the definition of the word? OR are you playing a dishonest game of semantics?

That said, if you want to talk a real Eugenicist


Please explain exactly how YOU are not a "real eugenicist". You fit the definition to a 't'.
Skepticus_Rex
1 / 5 (14) Jan 02, 2012
You aren't even citing the definition of the word "eugenicist." Try doing that and I will respond to a legitimate question based thereon. :)
RitchieGuy
1.3 / 5 (15) Jan 03, 2012
http://www.physor...lem.html

Full text of CrankHerbert's lunatic rant:

""Here is an inscription worthy of an ancient temple:

I, Frank Herbert, King of Physorg, have vanquished the scourge known as Pirouette, irrational ballerina VietNam[sic] veteran.

On 12/27/12011 Human Era, the scourge ceased posting ([url]http://www.physor...activity[/url] ). My best astronomers were able to determine via the unquenchable ferocity of the scourge's posting that the only explanation for his silence was banishment from the realm.

ALAS! He has returned in the form of NamVet666 ([url]http://www.physor...activity[/url] ). He will be vanquished again with even more tireless effort and ferocity than before. The people rejoiced at my proclamations. I love my people.

Pirouette, all your base are belong to us. You have no chance to survive make your time.""

Look out. . .he could be tripolar. :)
Vendicar_Decarian
4.7 / 5 (14) Jan 03, 2012
"However, the question as to any anthropogenic component to this warming (does not account for pre-1950 warming at all " - SkeptiTardRex

Why should it? Temperature changes come from a variety of sources. The warming from 1920 to 1950 isn't even statistically significant in that it is smaller than the natural level of climate variability, which is about .5'C.

Now during this time period the primary driver of the observed increase in temperature was the observed increase in the output of the sun, along with changes in land usage, and CO2 emissions from fossil fuels.

Currently, solar emissions are observed to be declining. Global temperatures are increasing.

FrankHerbert
3.3 / 5 (16) Jan 03, 2012
You aren't even citing the definition of the word "eugenicist." Try doing that and I will respond to a legitimate question based thereon. :)

Seriously? More extremely dishonest semantics?

a student or advocate of EUGENICS

-definition of "eugenicist" from Merriam-Webster. Not really necessary though anyone even slightly competent in English would know that even if he didn't know the meaning of the word "eugenics" which I have kindly provided twice above.

For the definition of "eugenics" see me previous post. Do you really think you are fooling anyone?

Please explain exactly how YOU are not a "real eugenicist". You fit the definition to a 't'.

Also Pirouette, I picked that thread to inscribe the "Acts of FrankHerbert" in because I find it flattering. Please continue posting it :)
Vendicar_Decarian
4.6 / 5 (10) Jan 03, 2012
RitchieGuy = NumenTard = RitchieTard.
Skepticus_Rex
1 / 5 (10) Jan 03, 2012
Finally, you cited the definition. You could have done without the blathering, though. :)

On both definitions of the word "eugenicist," the answer is 'no' on both counts. I am neither a student of nor an advocate of eugenics.

That said, I do, on the other hand, hope that people voluntarily use good sense in choosing to avoid spreading defective genes of a mental nature because of the negative impact that these people have on society. I do not study eugenics. I do not advocate eugenics in any way that would make me a eugenicist.

Now, it is true that you can take this word and apply it in a number of ways. For example, dog-breeders are eugenicists. Of course, I am not a dog-breeder, so I am not this kind of eugenicist, either.

In any case, you can go on and make whatever you want out of my rhetorical question that started you off on your quest to misunderstand. You will do it anyway--no matter what I write. The interesting thing is that my comment seems to have touched a nerve. :)
BigPink
not rated yet Jan 03, 2012
The problem with pre-empting genetic difficulties ala "final solution" outlooks (strong words I know) is that it seems to me it leaves out the better part of ourselves as well. We've met so many problems with creativity and growing technical prowess in part because we really wanted to see a loved one walk again, or see, or overcome a neurological difficulty. All of this has been a powerful inducement to advance the best in ourselves. The seeming efficiency of pre-emptive eugenic response cuts at our spirit of endeavor and makes us smaller. There's also this: many of our greatest poets, artists, scientists derived tremendous power from bipolar illness. Terrible and wonderful both. It would be good to find an address to the terrible and understand the wonderful. You won't find that in eugenics.
grassrootsgeek
not rated yet Jan 03, 2012
"Can society afford the costs?"

Eh. It'll be a drop in the bucket considering that society has to deal with small minds like YOU around.
Skepticus_Rex
1 / 5 (12) Jan 03, 2012
I agree with you, BigPink. The trouble is that we do not now have the means to cure these afflictions. The best that can result is the spread of the genes that cause the problems with only a stop-gap, partial treatment for those afflicted.

It is obvious that there are flaws with the genes that cause this sort of thing so only two potential options present themselves. We need to find a way to fix the flaws on a permanent basis. Technology is not yet there.

The other is to ask them not to bear children. But, how to ask people not to have children and thereby not pass these defective genes on to afflict more people in future? Those with mental conditions do not just affect themselves but everybody around them. There is no easy solution but can we afford the cost of passing more of these genes around without ability to fix the problems? We are decades off from being able to do that permanently.

I hate the idea of Eugenics but hope that some middle ground can be found in the interim.
Skepticus_Rex
1 / 5 (12) Jan 03, 2012
"Can society afford the costs?"

Eh. It'll be a drop in the bucket considering that society has to deal with small minds like YOU around.


I see I touched another nerve. Yet, the costs already are on the rise and will in the next few decades become staggering if the rate of increase keeps rising. Look deeper into this and understand why the rhetorical question to which you take exception.

For the record, I have a cousin who is mentally ill. His father has no relation to the rest of the family but has several other children besides the cousin. All of this man's children are mentally ill as he is. All have committed crimes and have destroyed the lives of many children, including snuffing the life out of siblings. All have cost the State hundreds of thousands of dollars each (including institutionalization, State-funded medication, criminal costs, and so forth). Yet, this man continues to breed even today. Having such a large mind as you claim in comparison, what is your solution?
grassrootsgeek
not rated yet Jan 03, 2012
"Having such a large mind as you claim in comparison, what is your solution?"

You're the one who is suggesting that there should be a solution other than researching better treatment. What's YOUR bright idea? You want the government to kidnap these poor bastards and castrate them or something?
FrankHerbert
3.3 / 5 (19) Jan 03, 2012
I do not advocate eugenics in any way that would make me a eugenicist.


Skepticus_Rex is a eugenicist as he has advocated eugenics in this topic. His playing with definitions is hopelessly dishonest.

I hate the idea of Eugenics but hope that some middle ground can be found in the interim.


Doesn't matter. You support it. Read your own comments.

For the record, I have a cousin who is mentally ill.


I guess you have black friends too, right? So that means you can't ever be a racist? FOR THE RECORD: I'm not calling you a racist. It's just a common theme among people who try to deny something that they are.

You are a eugenicist as you have ADVOCATED eugenics in this topic.
But, do we really want them reintegrated into society? While a humanitarian gesture, it also risks increased rates of breeding with the unaffected population, which will introduce more of this sort of element into society. Can society afford the costs?

^^^^^Advocating Eugenics^^^^^
BigPink
5 / 5 (5) Jan 03, 2012
Skepticus Rex:"I agree with you, BigPink. The trouble is that we do not now have the means to cure these afflictions. The best that can result is the spread of the genes that cause the problems with only a stop-gap, partial treatment for those afflicted."

SR, I'm afraid we do not agree at all. There's little point in belaboring it. If someone doesn't see how a thing works either by failure of imagination or husbanding a gloss of rationalisation to avoid a deeper think, it won't make any difference to reiterate logic rejected for personal shortcomings. ...And I'm afraid that's what I'm seeing here.
Skepticus_Rex
1 / 5 (13) Jan 03, 2012
You're the one who is suggesting that there should be a solution other than researching better treatment. What's YOUR bright idea? You want the government to kidnap these poor bastards and castrate them or something?


We need more than just better treatment. We need cures. Better treatment just allows more copies of the genes to enter society with no real fix in future.

I do not advocate the government doing anything, much less castrating them. But, something, somehow, needs to be done. I have no solutions, which is why I asked the rhetorical question that started this all off.
Skepticus_Rex
1.3 / 5 (14) Jan 03, 2012
No FrankHerbert, I am more into letting nature take its course in certain circumstances. In circumstances where the cost impact to society is significant, as in this case, I believe that sometimes nature should be left to take its course.

People left in said state will integrate less in society, resulting in lesser infiltration of these kinds of defective genes into the general society. These people still are left to make choices and others are still left to choose to mate with these kinds of people, whereas the stance of the Eugenicists would work more toward elimination entirely. My quasi-naturalist mindset would just lessen the impact on society naturally rather than artificially. In nature, these sorts of genetic anomalies end up going extinct.

In short, we need more than just shock-therapy treatments; we need cures for the genetic anomalies. Otherwise we risk driving humanity into extinction in the long term as these in time become a larger part of the genome than that without.
freethinking
1.7 / 5 (12) Jan 03, 2012
If anyone doesn't know yet, FH is using a lot of sock puppets to manipulate rankings.
Arf_Arf_Arf_Arf_Arf_Arf
1 / 5 (6) Jan 03, 2012
snifsnifsnifsnifsnifsnifsnifsnif gag... and as we know sockpuppies do stink.