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New neurosurgical procedure may prove helpful for patients with treatment-resistant depression

Published on October 14, 2009 at 2:38 AM · No Comments

Researchers at Medical University of South Carolina pioneer bilateral epidural prefrontal cortical stimulation

A new neurosurgical procedure may prove helpful for patients with treatment-resistant depression. Bilateral epidural prefrontal cortical stimulation (EpCS) was found generally safe and provided significant improvement of depressive symptoms in a small group of patients, according to lead researcher Ziad Nahas, M.D. at the Medical University of South Carolina. The data are reported in the on-line issue of Biological Psychiatry.

Treatment-resistant depression is a recurrent psychiatric illness and a leading cause of premature morality due to suicide and associated medical conditions. In the U.S., more than 3.2 million patients are diagnosed with treatment-resistant depression. Typically, patients have tried several medications and treatments without success or improvement.

EpCS targets electrical stimulation to the anterior frontal poles and the lateral prefrontal cortex. "We focused on these two regions because they are part of a larger brain networks critical in regulating mood. Both play complementary roles integrating emotional and cognitive experiences and offer a distinct opportunity for targeted antidepressant treatments" said Dr. Nahas, an associate professor of Psychiatry, Physiology and Neuroscience and Director of the Mood Disorders Program at MUSC. "Cortical stimulation has several advantages provided that it shows efficacy in treating depression. It is reversible, non-destructive and potentially safer than other forms of invasive brain stimulation since the stimulating paddles don't come in direct contact with the brain." His team included MUSC neurosurgeon Istvan Takacs, MD and MUSC anesthesiologist Scott Reeves, MD.

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