Treatment via brain stimulation
There are different kinds of brain stimulation. The ones being currently used are listed below: Electro convulsive therapy: this procedure works by attaching electrodes to the both the sides of the temples. The aim is to produce seizure for a minute and after which the brain goes back to normal level of functioning. Electric currents for durations ranging between 30 to 90 seconds are administered. The patient is given anesthesia and muscle relaxants prior to the procedure.
This treatment is effective in the short term. Its long term benefits are not known. Common side effects include headache, stiffness and short term memory loss.
Tran’s cranial magnetic stimulation:
The normal belief is that the brain contains certain excitatory and inhibitory nerve processes. These may be out of balance leading to disorders. TMS aims at restoring this balance by increasing or decreasing excitation and inhibition in brain pathways.
The procedure involves holding a hand held coil to the scalp (contact with scalp is not necessary) and passing strong current round the coil. This causes a magnetic field that passes through to the brain. When the current is fluctuated the magnetic field is rapidly fluctuated causing tiny secondary currents in the brain.
The benefits of rTMS are still not fully proved. Lots of research and experimentation has to take place before TMS can be used in clinical routine practice.
Vagus nerve stimulation:
A stop watch size generator is implanted in the upper left part of the chest. A thin wire runs below the skin up to the left vagus nerve in the neck. Here lead is attached to the wire which is placed round the branched vagus nerve. Stimulations are sent from the generator every five minutes the whole day long. Stimulations do not last more than 5 to 30 seconds at a time.
After a year of treatment 1 out of 3 patients showed a great mood improvement. Success rates differ. Some enjoyed the benefits within a few weeks and some got the benefits within a year. Some of the benefits include increased energy levels, social functioning and emotional well being and having positive thoughts.
Deep brain stimulation
This is a two fold surgery. Surgery for the brain is done under local anesthesia. The patient has to be conscious to inform result. Two holes are bored in the skull. Thin hairs like electrodes are implanted. Electrodes are attached to the generator that is implanted in the chest or stomach. Generator passes stimulation to the brain at fixed intervals twenty four hours a day.
The success rates are satisfactory enough to carry out further investigations.
The various method outlined are still in their infancy. Long term benefits have not yet been proved. If further research bears fruit then these will help patients who have incurable depression. Out of the 121 million depression sufferers 15-30% of them have depression non responsive to treatment.