Posts tagged ‘EpCS’

October 14, 2009

new treatment for depression?

There’s a new treatment for treatment-resistant depression.

Epidural prefrontal cortical stimulation (EpCS) targets electrical stimulation to the anterior frontal poles and the lateral prefrontal cortex. According to Dr. Ziad Nahas, director of the Mood Disorders program at the Medical University of South Carolina, “We focused on these two regions because they are part of a larger brain network critical in regulating mood. Both play complementary roles integrating emotional and cognitive experiences and offer a distinct opportunity for targeted antidepressant treatments.”  One of the main advantages is that EpCS is a reversible procedure that is non-destructive and because the stimulating paddles don’t come in direct contact with the brain, it’s potentially safer than Deep Brain Stimulation (DBS).

How It Works-

Five patients were implanted with EpCS over the anterior frontal poles and the lateral prefrontal cortex bilaterally. Four separate paddle leads were then connected to two small generators surgically implanted in the upper chest are of the patient. The researchers individualized the treatment parameters for each patient to maximize the long-term antidepressant effects. They relied in part on input from the patients themselves who signaled positive mood changes when first stimulated. In general, their devices were set to periodically deliver electrical charges at intensities below the seizure threshold. The devices were never active at night. Only patients who failed to respond to several antidepressant treatments – including medications, psychotherapy, transcranial magnetic stimulation, vagus nerve stimulation or electroconvulsive therapy, were included in the study.

Patients were closely followed after the surgical implant and evaluated regularly using standard clinical ratings. After seven months, the average improvement was 54.9 percent based on the Hamilton Rating Scare for Depression and 60.1 percent on the Inventory of Depressive Symptoms Self Report. Three of the patients reached remission. One patient experienced a scalp infection that required removing the implants over the left hemisphere.


For more information:

article from Biological Psychiatry

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