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Physicians from the University of Bonn, together with colleagues from the US, have suggested a new target structure for deep brain stimulation (as it is technically called). They hope to achieve an even better success rate with fewer side effects. The work has been published in the renowned “Neuroscience and Biobehavioral Reviews.”

In deep brain stimulation, physicians implant electrodes in the brain. Using an electrical pacemaker implanted under the patient’s clavicle, physicians can influence the function of certain areas of the brain in a lasting manner. The method was originally developed for treating patients with Parkinson’s disease in order to alleviate the typical movement problems.

Lasting Improvement
For several years, the method has also been investigated in the treatment of the most severe cases of depression, with striking and completely unexpected success: In patients who had undergone many years of unsuccessful treatment, the symptoms sometimes significantly resolved. The most striking aspect: “Depression does not return in patients who responded to the stimulation,” emphasizes Professor Dr. Thomas Schläpfer from the Bonn Hospital for Psychiatry and Psychotherapy. “The method appears to have lasting effects – and this is in the case of the most treatment-resistant patient group described in the literature. This has never before happened.”

Deep brain stimulation has been tested to date in three different areas of the brain: the nucleus accumbens, the internal capsule, and a structure known as cg25. Surprisingly, the effects are nearly identical – regardless of which of these centers the physicians stimulate. Together with colleagues from Baltimore and Washington, the Bonn researchers have since been able to explain why this is the case. Using a novel tomography method, they were able to make the “cable system” of the three brain centers visible. “In doing this, we determined that at least two of these three areas – probably even all three – are attached to one and the same cable harness,” explains the Bonn brain surgeon, Professor Dr. Volker Coenen.

This is the so-called medial forebrain bundle, a structure which has been known in animals for a long time. The forebrain bundle forms a kind of feedback loop which allows us to anticipate positive experiences. “This circuit motivates us to take action,” says Coenen. “In patients with depression, it is apparently disrupted. This results in, among other things, an extreme lack of drive – a characteristic symptom of the disease.”

The nucleus accumbens, internal capsule, and cg25 all appear to be connected to the medial forebrain bundle – rather like leaves are connected to the branch from which they arise. Whoever stimulates one of these regions of the brain simultaneously influences the other components of the motivation circuit to a certain extent. Coenen, who was the first to anatomically describe the forebrain bundle in humans, now proposes implanting the electrode for deep brain stimulation directly into this structure. “We would use the electrode to send the current pulses to the base of the network and not to the periphery, as before,” explains Schläpfer. “We could thus potentially work with lower currents and yet achieve greater success.”

A comparatively low-risk procedure
Observations of patients with Parkinson’s disease appear to support this idea: in this case, a network of brain structures responsible for movements is stimulated. The more basally (figuratively speaking: near the branch) the electrical stimulation is applied, the greater its effect. At the same time, the risk of adverse side effects is reduced.

By now, more than 80,000 patients with Parkinson’s disease worldwide have a brain pacemaker in their body. “Experiences to date demonstrate that the brain intervention necessary for this is relatively low-risk,” stresses Professor Coenen. “Thus from a medical point of view, there is nothing that argues against also using this method to help people with very severe depression.”

Material adapted from Universitaet Bonn.

Reference
Coenen VA, Schlaepfer TE, Maedler B, & Panksepp J. Cross-Species Affective Functions of the Medial Forebrain Bundle -Implications for the Treatment of Affective Pain and Depression in Humans. Neurosci Biobehav Rev 2010 Dec 21. doi: 10.1016/j.neubiorev.2010.12.009

Remember to stay safe and healthy over this holiday season.

Our very best wishes,

Christopher Fisher and the BMED Report Contributors

Happy Holidays!

Wishing you and your family the very best,
Christopher Fisher and the BMED Report Contributors

We still have a kink or two to work out, but overall things went pretty smoothly. We appreciate everyone’s patience and support while we went through this major upgrade to our website!

CFisher

By the way, these new “cloud servers” are expected to provide lightening fast page load times, the ability to handle larger spikes in traffic, and improved overall reliability. We hope that you enjoy these upgrades in the coming weeks.

CFisher

Of course, The Behavioral Medicine Report is a live and active website. We basically have two ways to go about this major overhaul: (1) shut the website down for a day or two or (2) implement changes while the website is live. I have decided to live life on the edge and go with option 2. Readers should expect some occasional layout issues or design irregularities until all modifications are ironed out. We truly hope that these changes do not completely interfere with readers’ access to articles (crossing fingers and toes).

All of us at BMED Report hope you enjoy the new look! Feedback is greatly appreciated, particularly if you experience difficulties with the new website.

Enjoy.

CFisher

As always, we thank you for your support of this website. We could not exist without your dedicated readership. Our writers will continue to work hard in 2010 to bring you the very best psychology reviews, articles, and news.

Best regards from your friends at The Behavioral Medicine Report,
Chris Fisher

Merry Christmas!
Chris Fisher

We strongly believe and hope that our readers will find information gleamed from The Coherence Newsletter to be interesting and informative. I plan to have the first republished article posted within 24 hours. And as always, thanks for your continued readership.

Enjoy.

CFisher

As always, the writers at BMED Report thank you for your readership and support.

Enjoy.

CFisher

My hope is that our readership continues to grow exponentially over the next year. Another major goal is to recruit additional authors to help post new articles. As I transition from my graduate student role to a licensed psychologist next year (hopefully!), it will more and more difficult to maintain the website without significant help. If you are interested in contributing, please feel free to Contact Us. I plan to share advertising revenues with our authors if BMED Report continues to expand and advertisers start to purchase ad space; hence, enterprising graduate students and healthcare professionals could eventually receive extra monthly income for their efforts. Of course, all authors also get free advertising through our User Community. But enough business talk…………..

Happy Birthday to the Behavioral Medicine Report!!

CFisher

Enjoy

CFisher

Additionally, I plan to open up comments (which has been previously closed) to our reports to select persons. Even comments will need to be based on available research as I want to maintain our evidenced-based focus. A little tedious I know, but The Behavioral Medicine Report does not want to contribute to the spread of misinformation about healthcare found all over the internet. See the end of this article for more detailed information about the writer/commenter roles.

A little more about the roles of writer and commenter:

A primary goal will be to maintain a high level of quality writing that our readers have come to expect. Therefore, we seek graduate psychology, counseling, and medical students and licensed healthcare professionals (physicians, nurses, rehab specialists, etc.) to become writers and/or commenters. If you have good written skills and enjoy writing about or commenting on healthcare research, please use the Contact Us page to email us your interest.

As a writer, you will select research articles, books to review, science research news, or interesting/useful clinician resources of your interest as long as they are consistent with our primary mission. In short, the specific topic and length is up to you, and you can write as frequently (or infrequently) as your schedule allows. Writers will be given commenting privileges too. Your biography will also be published in the About Us section.

If you want to participate on this website, but do not have the time to write full articles, then you should consider becoming a commenter. As a commenter you can comment on our stories (similar to traditional blogs). Comments must be based on available research evidence; otherwise if your comment is based on clinical experience or an outright opinion, then you must state this in your comment.

Please feel free to contact us for more information. I look forward to hearing from you.

CFisher

I want to take a moment in my first post to introduce myself and this website. My name is Christopher Fisher, M.A. I have master’s degree in Clinical Psychology from Texas A&M-Corpus Christi, and I am currently a 4th year doctoral student in Clinical Health Psychology and Behavioral Medicine at the University of North Texas.  My doctoral program is somewhat unique in its multidisciplinary approach.  In addition to traditional clinical psychology courses, students in our program study health psychology, pharmacology, physiology, applied behavioral analysis, immunology, and even biofeedback.  I chose to further specialize in neurofeedback (“EEG Biofeedback” or “Neurotherapy”), Cranial Electrical Stimulation (“CES”), and quantitative EEG (“QEEG” or “brainmapping”).  Don’t worry if some of this sounds foreign to you. I’ll explain more on these and other topics in future posts.

In coming the weeks and months, I plan to update this website as often as my time allows and when there is something interesting to talk about.  I am very excited about psychology and its cognitive and behavioral based treatments, as well as “alternative” treatments such as neurofeedback and CES. My nose is seemingly buried in books and research articles much of the time, and I frequently come across interesting and/or vital psychology research I want to share with the public. I will do my best to keep the discussions in laymen’s terms; after all, this website is worthless if no one understands what I am talking about.  Enjoy!

CFisher

Important Disclaimer: The information provided on The Behavioral Medicine Report is intended for your general knowledge only and is not a substitute for professional medical or psychological advice or treatment for specific medical or psychological conditions. Always seek the advice of your physician, or other qualified health care provider with any questions you may have regarding a medical condition.  Always seek the advice of your physician or psychologist or other qualified health care provider with any questions you may have regarding a psychological condition. The information on this website is not intended to diagnose, treat, cure or prevent any disease. Never disregard medical advice or delay in seeking it because of something you have read on The Behavioral Medicine Report.