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FDA OKs Brain Pacemaker for Depression
Duke Machesne writes "On Friday, the FDA approved a new therapy for the severely depressed who have run out of treatment options: a pacemaker-like implant that sends tiny electric shocks to the brain. The Food and Drug Administration's clearance opens Cyberonics Inc.'s vagus nerve stimulator, or VNS, as a potential treatment for an estimated 4 million Americans with hard-to-treat depression - despite controversy over whether it's really been proven to work."
let the numerous tinfoil hat references begin!
I want to delete my account but Slashdot doesn't allow it.
First post! (Always wanted to say that) But in reality, isn't this the same treatment for severe cases of Parkinson's? Have those patients shown mood changes as well?
Shockings will continue until morale improves!
Agile Artisans
I wouldn't trust it. My room/cell mate had one and it didn't seem to do him any good, although his was for treating epilepsy.
Philosophy.
Wuhoo! Now I can be a wirehead with FDA approval.
Happy, Happy, Joy, Joy, Joy!
Taking guns away from the 99% gives the 1% 100% of the power.
Just imagine if you got one of these things implanted in your brain and it didn't work at all - that would be extremely depressing. :-)
Electric Monkey Pants
*BZZT*
Vagus baby, YEAA!!
US$0.02++
I'm sure there is something snappy I could say here... but I'm really not in to it today...
I think I'm going to go back to bed
For the answer, read or watch Michael Crichton's "The Terminal Man". One of his better stories, from about 30 years ago.
-- You are in a maze of little, twisty passages, all different... --
I wonder how hackable they would be to send 'pleasure' signals... Kinda like a star trekkie thing that keeps your brain in extacy for hours upon hours... That would be the life... who cares about money after that implant.
Seriously, Depression is a dissease that affects almost everyone at some point in our lives. Those who cant be helped with alternative methods could serously benefit from such. Whats needed now is a way to determine if someone is clinincally depressed even if they are denying it. This might have pain and suffering of a local 13 year old who tried to take his own life last winter, but only succeded in making himself worse off.
Please remember that the FDA has approved this device only for treatment-resistant depression. This is not first line therapy.
Theory: Many instances of depression are due to social injustice, apathy, the slow pace at which society reforms itself.
Concern: If we drug or electrically stimulate ourselves to keep ourselves happy, social progress comes to a halt. We feel good about ourselves, even though horrible things happen around us.
Here is a bibliography kept by AdBusters. I'm not sure how reliable a bibliography kept by AdBusters is, but these are things that we should be thinking about, and research that we should at least consider.
The medieval Latin word vagus means literally "wandering" (the words "vagrant", "vagabond", and "vague" come from the same root).
This nerve supplies motor and sensory parasympathetic fibres to pretty much everything from the neck down to the first third of the transverse colon. In this capacity, it is involved in, amongst other things, such varied tasks as heart rate, gastrointestinal peristalsis, sweating and speech (via the recurrent laryngeal nerve).
The vagus also controls a few skeletal muscles, namely:
* levator veli palatini muscle
* salpingopharyngeus muscle
* stylopharyngeus muscle
* palatoglossus muscle
* palatopharyngeus muscle
* superior, middle and inferior pharyngeal constrictors
* muscles of the larynx (speech).
This means that the vagus nerve is responsible for quite a few muscle movements in the mouth and also is vitally important for speech and in keeping the larynx open for breathing.
It also receives some sensation from the outer ear and part of the meninges.
The vagus nerve and the heart
Parasympathetic innervation of the heart is mediated by the vagus nerve. The right vagus innervates the SA node. Parasympathetic hyperstimulation predisposes those affected to bradyarrhythmias. The left vagus when hyperstimulated predisposes the heart to AV blocks.
I'm really feeling down. I just don't know how long I can ZOT! Hey, I'm ready to rock and roll! I think I'll become president of the world! But that would mean having to find an apartment in a big city, and I wouldn't see my wife and kids very much, and I probably wouldn't get to watch reruns of Enterprise. Gawd, they cancelled Enterprise, I can't believe it, no more Star Trek, that's it I'm going to open this window and ZOT! Hey, good riddance, goddamn Enterprise, crappy acting, crappy stories, thank goodness there's Battlestar Galactica. Much better writing, interesting stories. And there's Doctor Who too. Great remake. But Christopher Eccleston isn't coming back for the second season. It'll fail for sure, then I won't have anything to watch and I'll sit in this apartment reading Slashdot crap on my computer. How can I deal with this? I think I'll tie rocks to my shoes and ZOT! Hey! That's okay, I've always got Slashdot. Maybe I'll get moded +48183 Insightful for this post, become King of Slashdot and supplant CmdrTaco! Oh, but then people will mock me, and call me a shill, and claim I do nothing but post dupes. I can't stand that. I'd rather ZOT! ZOT! ZOT! ZOT! ZOT!
The world's burning. Moped Jesus spotted on I50. Details at 11.
Because randomly stimulating a single nerve tract to cause the release of neuro -ransmitters is easy while the more precise stimulation needed for perception is very hard (and almost not at all understood). For those unfamiliar with neuro-anatomy the vagus nerve goes throughout the body and (primarily) picks up signals on heart rate etc. that are associate with an increased level of arousal. This nerve projects (again primarily) to the amygdala the brains "emotional center" so your brain knows your scared, excited, elated or any other state of high arousal (because often your body reacts before your brain does, altough this is a simplistic explanation) So all this device seems to do is cause a higher level of arousal. It doesn't seem to do much more than current drugs already do, except maybe that the level of control is more precise than just popping a pill.
Actually the tasp was the remote version of it, so you could "Make someone's day" by remotely You are thinking of a droud.
And why is it only for the severely depressed? Why can't the merely morose get it, too?
How about those of us who have just realized that our lives are going nowhere, but other than that we're mostly ok? Don't we get any shock treatments?
I think it could help a lot of people get from "mostly happy" to "Wow, this is a great time to be alive!"
And I wonder if it runs Linux.
Personally, when I feel down, I remember the old adages: a gramme in time saves nine. Not to mention, a gramme is better than a damn.
Isn't it great to be an epsilon minus? We even have our own dedicated chatboard, Slashdot, to share our experiences.
"A door is what a dog is perpetually on the wrong side of" - Ogden Nash
(for whomever labelled this as flamebait)
This is a reference to Niven's universe, I've heard it first mentioned in the book "Flatlander." Basically, a wirehead is somebody who has become a current addict. A hole is drilled into the skull, and a wire inserted into the pleasure center of the brain.
The end result is that the person becomes addicted to the pleasure supplied by the device, worse than a cokehead or heroin addict.
Addiction should be something we should be careful of, we don't need "wireheads" outside of book-worlds.
How about some more factual information? NPR has done several stories on this kind of treatment, and how it is (and isn't) used. This is not "rats push the button to feel good". This treatment involves a very precise electrical impulse delivered to the malfunctioning area of the brain; it is to electro-shock therapy what a bonsai knife is to a lawnmower, so the side effects, while not well-characterized, are likely to be orders of magnitude less intrusive.
It's used in cases where the depression is not treatable with current drugs. These are people who are so seriously neurochemically depressed that suicide seems attractive for the relief it would offer. The best we could give them before was a hug and a doctor mumbling that they were "interesting," until eventually they gave up and killed themselves. Now we can offer them this, which has at least one major advantage over suicide.
Because what happens in vagus stays in vagus.
I kinda agree with you here.
I'm a depressed person. While I've not been officially diagnosed, I think the recent suicide attempts have proven that.
Now, I don't fucking want help. I rather like being this far below the average person. It's easier down here. No one understands that, and I'm expected to "get better" so that my friends and family will "feel better" about me.
Why does depression have to be cured?
it's because they don't know the history of psychiatry. and ONLY tom cruise knows the history of psychiatry. and we should be happy, because one day he will be allowed to tell us the history of psychiatry that he knows.
The advice we ultimately adopted was that the VNS had too low a success-rate in reducing seizures (even in some cases increasing seizure ativity). That it would help those suffering from various physiological depressions was mentioned as a passing thought.
The VNS is implanted under the skin with leads connected to the vagus nerve -- the device could be manually activated by positioning a magnet over the implant. For epileptics, this was the thing to do when the aura (premonition) came. However, my wife has never had aura before a seizure, so the ultimate benefit was moot (what with my time machine being broken, and all.)
Personally, mild electric shock therapy *could* be of benefit, but mostly I suspect the manufacturer, having lost the "VNS cures epilepsy" headline, are going for a second (but much larger) market.
Your mileage will vary.
Can you say Harrison Bergeron? I though you could.
You could say that, but you would be wrong:
- The handicap helmet George Bergeron wore in the essay emitted sounds, not electric shocks.
- The helmet was designed to keep George down, i.e. to disrupt his brain/thought patterns, not to resolve any problem he might have had (unlike the device in the article).
One of many places to read Harrison Bergeron in its entirety.
I want to drag this out as long as possible. Bring me my protractor.
Well, Tom Cruise is not entirely incorrect (although he's certainly insensitive, and somewhat insane).
The idea of depression being "due to a problem with the brain" is something of a misconception; of course it is one that has been promoted and reenforced by pharmaeutical companies.
Any mental state has a corresponding underlying physiology, but it really isn't correct to say one causes the other - to say the physiological state of the brain "causes" depression. Certainly when people become depressed that is associated with chemical changes in brain function. But cognitive behavioral therapy is (in most cases) as successful as drug treatment, and best results are when you use both. In other words, depression is cured by either changing thought patterns or by changing the chemical physiology of the brain, but really these two things are just two sides of the same coin.
To say that depression is a simply physiological disorder is misleading at best. Since all mental function is grounded in the biology of the brain, any mental state can be affected through a physical intervention, but that doesn't mean the state is "purely biological" or "caused" by brain function. For example, neuroimaging studies have shown that some of the abnormal patterns of brain activation you see in obsessive compulsive disorder change as a result of cognitive-behavioral therapy, that is, changing thoughts and behavior without drugs.
Zoloft, IIRC, took 3 tries to find a study where it performed better than placebo, and when it did it wasn't all that much better (has *some* effect on 70% of cases, or the like). I may be misremembering, but the point is sound -- *all* depression treatments at this point have pretty high fail rates, and if you've seen serious depression, you know that *any* new tools are welcome.
...
Elsewhere it's been pointed out that truly successful depression treatments could mask problems in our society, the same way that truly successful cancer treatments could mask pollution problems. That's true -- but if your mother is dying of cancer, it's sure hard to care
Define 'insane'?
Tom Cruise.
The idea of depression being "due to a problem with the brain" is something of a misconception; of course it is one that has been promoted and reenforced by pharmaeutical companies.
Although I would love to agree with this, having issues with depression for over 20 years, I believe that I know a thing or two about it.
I have bipolar disorder (aka manic-depression), and I do need to be on medication to control it. I cannot say that situational events outside of my brain chemistry have no effect on my mood like anybody else, however I do go through distinct mood swings, even with medication.
A brief description of bipolar disorder goes like this -- Depression is the underlying issue for both the depressive side (duh) and the manic side. This is from what I understand, and it matches my experience as well, the manic phase is due to a biological reaction to being so depressed for an extended period of time. I compare it to anorexia-nervosa. There is an ironic characteristic with anorexia where the body goes into hyper mode after dropping below a certain level of fat tissue in the body that puts the body into "flight" mode. Biologically, one theory behind this is that it is a survival trait that when the body is without adequate food for a certain time, the body goes into overdrive so that the individual can have the energy to relocate and get food and survive.
Granted, I don't believe that there is much of a survival aspect with being manic as with the anorexic, but mania does appear to be a reaction to being depressed for an extended period of time. In fact, if I only take an antidepressant without a mood stabilizer as well, I will go into a manic phase fairly shortly.
I would love to be free of medication, the responsibility to take it, its cost, and the side effects, but I have come to accept that the positives of taking the meds outweighs the negatives. Now, its not like if I stop taking my meds I will be in a bad state within a week to two. It could be up to a year, depending on other things. Its a matter of when, not if.
I will say that being depressed sucks. In itself, being depressed is depressing. I loose interest and motivation to do things. I don't care about much. I can get into a compulsive work mode in an effort to make myself feel better, but it really only keeps my mind off of things. I get this empty bottomless pit feeling in my gut, and I simply do not feel good. I don't want to be around people or go out, I would rather just sit in my misery. When I'm very depressed, I can hallucinate a bit.
Now, being manic can be fun to an extent. The best way that I can explain it to most people is that it is like being on LSD for weeks or months at a time. I have gone without sleep for a good part of 2 weeks. I can get into very interesting sexual situations. I'm slightly psychic. I have very racing thoughts and mood swings throughout the day where I'm irritable and cranky to full of life and the life of the party. I have the attention span of a fly. Its almost impossible to do something like read or anything else where I have to sit still for an extended period of time.
I will also mention that I know a few people with my disorder as well. I'm unsure if anybody has it as severe as I do. As far as the manic-depressive scale goes, I'm off the charts. The most extreme manic swing is characterized as having psychotic features (manic psychosis, I believe) and that is where I have been, although not in years. Also, its worth noting that every time an individual goes through a manic episode, it impairs the person even further each time. I've seen an older woman that was bipolar that I believe (and the court believes) that she will never be able to function on her own.
Now, back to the skeptical view. I do believe that depression is over diagnosed and I find it difficult that humans have evolved over the years into a more depressed group of people. It does not biologically make sense. Aside from some benefits of be
I'm a depressed person. While I've not been officially diagnosed, I think the recent suicide attempts have proven that.
I'm not sure how much they "prove" at all, except that you want them to "prove" something.
Now, I don't fucking want help. I rather like being this far below the average person. It's easier down here. No one understands that, and I'm expected to "get better" so that my friends and family will "feel better" about me.
No, you're just a self-indulgent kid who wants to exploit some of your alienation and loneliness to make yourself feel better than everyone else.
Depression isn't fun, and it doesn't make most people cool or interesting.
It's like having a damn weight round your neck, slowing you down, and the more you slow down, the more weight gets added. It's being surrounded by a fog such that you can't even see what "normal" is, destroying your motivation further, because you can't see that making the effort to work your way out of the depressive rut your in will get you anywhere worthwhile. So you do nothing and it gets worse.
That's not to say that I'd want to be a blindly optimistic person; being less than blindly happy can be a good thing and stop you being a brain-dead zealot. The experience, I'd guess, could be used for constructive purposes.
But depression is not fun, it's not interesting, in fact it's bloody boring and (real depression) is just as likely to turn you into a boring person to be with as it is to make you a poetic genius (which requires some motivation, in short supply).
It needs some will-power to actually say "fuck it, this does not apply to my life", externalise your depression and frankly to not indulge it.
Why does depression have to be cured?
I'm very sceptical that it *should* be "cured" in the way that many would like it to be. Yeah, pop your angsty teen some pills when they start feeling less than satisfied with your messed up, materialistic values, stick something in their head, yadda yadda.... sometimes it's a natural reaction to the environment someone's in, and "curing" it with science is frankly loathesome.
And on the other hand, the boring, unfashionable, (but very destructive) drizzly fog-like depression that some people have is just likely to be unbearable, and my guess is that anyone depressed to that extent (I've never been that bad, but I can at least imagine it) would not ask "why does depression have to be cured?".
"Slashdot - News and Chat Sites Deviant". (Click "homepage" link above for details).
...info copied wholesale from Wikipedia, and largely irrelevant to the story, really ought not to be modded up.
Doesn't it make you feel good to know that our freedoms are protected by politicans, lawyers and journalists.
After seeing the flood of speculation and information based misunderstanding so endemic to a /. discussion, I thought I'd add a personal comment.
My brother is 45 years old, and has had severe epilepsy since he was 3 years old. He is also learning disabled and orthopedically handicapped. Epilepsy, as you may or may not know, is the brain's equivalent of a 'lightning storm'. The cause varies, and the most common treatment is a combination of drugs and surgery to reduce either the beginning of the epileptic seizure or slow the propagation of the wave of activity across the cereberal cortex.
In many patients, drug therapy has to be regularly fine-tuned or completely changed. Think of it as regular security patches, because the brain figures ways to hack around the chemical defenses. In some patients, the brain is so good at hacking through the barriers that drug therapy loses effectiveness. This happened to my brother.
An FDA approved treatment for patients in this condition is the use of a Vagal Nerve Stimulator (VNS). He has a controller/power source implanted in his shoulder, a wire threaded up inside his neck, and the eletrode implanted next to the Vagal Nerve. This nerve is down in the brain stem / 'hindbrain'. Every 5 minutes the controller sends a signal(started at 250mv, it's up to 500mv) for 30 seconds into this electrode. If we want to, we can command a pulse our of sequence by passing a strong magnet over the controller.
The results have not been Science Fiction Movie class miraculous, but they have been visible. For the first few days he would physically react to the pulses (facial tick/jerk, shoulder hunch, etc..). After three months, he no longer reacts as visibly.
But, his grand mal seizure activity has dropped. His petit mal seizure activity has dropped as well. He's improving ! He is more alert, vocal, communicative, and is cracking jokes once again.
I don't know how it will work on depression, but I can tell you from personal observation that it seems to work for epilepsy !
Just last month my son had a VNS inserted. This was for epilepsy, and not for depression, and it was quite a trial to be approved for the device. But this was the last resort after years of drug therapy and before major brain surgery for the child. Here's a few observations that might help clarify the whole VNS system:
It is an automatic device that delivers a specific frequency, amplitude, peak duration and general duration of electric shock. There is a "always on" mode where the shock is delivered for 60 seconds, followed by 66 seconds off, repeated indefinately. There is also a mode that is activated with a magnet. This mode is usually programmed to deliver the same frequency and duration, but more amplitude to the shock. The setting of these attributes is done via a PDA and a "wand".
Hackable, I suppose. My curiosity had me wishing for a signal meter to find out the attribute-setting protocol (but dang if I left it at home). But will it solve depression? The only results I've seen are children 10 to 18 who have a life because of this little device. Other than helping regulate seizure behavior, the only obvious side-effect is a slight warbling of the vocal cords. If anything, my boy thinks it's cool that he's now a cyborg and shows off to his friends. He's happy so far, but the real results will come with time.
As was the case for my son, I feel there should be a real medical need before having the VNS surgically inserted. In the case of seizures, it is difficult to operate without some method of control. I have never liked the amount of medications my son needed to refrain from regular seizures, and this seems like a reasonable alternative to having chunks of his brain surgically removed.
If a subject has debilitating depression, then maybe the VNS would be worthwhile for them. But from my perspective, the VNS is a good thing.
H0ek
Think you're smart? Prove you've got brains!
All the SF reference compared with this are wrong.
All the comparisons about deep brain stim, anti-ictal stim, TENS, etc., are wrong. They're similar in that electricity is used. It's different according to the voltage, freqency and placement.
As for the invasiveness of them (except TENS), that's not good, but we're working on it. If we can get TMS (transcranial magnetic stimulation) to focus down small enough, get a more portable power supply, and get a probe that's significantly smaller than the present ping pong paddle sized device, we'll have a definite improvement over the best available now.
"I may be synthetic, but I'm not stupid." -- Bishop 341-B
Well, heart pacemakers are certainly treating symptoms rather than curing the disease. Does that make them worthless?
There is a point where treating the symptoms is valid. If you remove all the symptoms, then you don't really _need_ to cure the cause, do you?
Politas
you are only talking about situational depression, which everybody gets sometimes in their life. clinical depression is an imbalance of chemicals in your brain, making you be depressed even when everything is great in your life. you obviously do not know any clinically depressed people and you haven't read any medical books on the subject. don't try and tell people you have an answer... you will only make things worse.
Meh.
Sorry to hear about your disease. Nevertheless, you cannot deny the objective evidence with regards to NE and 5-HT (in the locus coeruleus, etc.). With that in mind, we have seen clear objective evidence that drugs such as SSRIs have significantly improved the lives of (and "cured") many people.
I assume that you know some of the drug treatments available; Effexor, Wellbutrin, Zyban, Celexa, Prozac, etc. I also assume that you know that ECT is another treatment option for major depressive disorder refractory to other treatment.
You simply cannot take your single example and suggest that your self-medicating is a solution that will work for everyone. It may (appear to) work for you, but suggesting that you do not have a neurochemical imbalance isn't necessarily objective.
Do you what one of the major causes of death is with people who have major depressive disorder? Suicide. Not a good thing.