It can be challenging to create a treatment plan for depression. This is especially true for patients who aren’t responding to conventional treatments and are undergoing experimental therapies such as deep brain stimulation. For most medical conditions, doctors can directly measure the part of the body that is being treated, such as blood pressure for cardiovascular disease. These measurable changes serve as an objective biomarker of recovery that provides valuable information about how to care for these patients.
On the other hand, for depression and other psychiatric disorders, clinicians rely on subjective and nonspecific surveys that ask patients about their symptoms. When a patient tells their doctor they are experiencing negative emotions, is that because they are relapsing in their depression or because they had a bad day like everyone does sometimes? Are they anxious because their depression symptoms have lessened enough that they are experiencing new feelings, or do they have some other medical problem independent of their depression? Each reason may indicate a different course of action, such as altering a medication, addressing an issue in psychotherapy or increasing the intensity of brain stimulation treatment.
We are neuroengineers. In our study, newly published in Nature, we identified potential biomarkers for deep brain stimulation that could one day help guide clinicians and patients when making treatment decisions for those using this approach to alleviate treatment-resistant depression.
Deep brain stimulation involves surgically implanting electrodes in the brain.
Biomarker for depression
Clinical depression does not respond to available therapies in a significant number of patients. Researchers have been working to find alternative options for those with treatment-resistant depression, and many decades of experiments have identified specific brain networks with abnormal electrical activity in those with depression.
This notion of depression as abnormal brain activity rather than a chemical imbalance led to the development of deep brain stimulation as a depression treatment: a surgically implanted, pacemaker-like device that delivers electrical impulses to certain areas of the brain. Studies testing this technique have found that it can decrease depression severity over time in most patients.
Our research team wanted to find specific changes in brain activity that could serve as a biomarker that objectively measures how well deep brain stimulation is helping patients with depression. So we monitored the brain activity of 10 patients receiving deep brain stimulation for severe treatment-resistant depression over six months.
At the end of six months, 90% of the patients responded to the therapy – defined by a reduction of symptoms by at least a half – and 70% were in remission, meaning they no longer met the criteria for clinical…