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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.
Shockings will continue until morale improves!
Agile Artisans
Happy, Happy, Joy, Joy, Joy!
Taking guns away from the 99% gives the 1% 100% of the power.
I don't know about parkinson's, but the same device is used to treat severe epilepsy.
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
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.
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.
isn't this the same treatment for severe cases of Parkinson's?
No, the device you're thinking of is the thalamic stimulator. It's implanted in the brain, with the patient conscious, and I read somewhere that the results are dramatic, so much so that surgeon looks at the patient's hand, probes on the thalamus with the electrode to find the right spot, and when he finds it, the shaking instantly stops. I hear when the implant is in place and working, the only reminder of Parkinson's disease left is slowness of movements, but no more tremors.
"A door is what a dog is perpetually on the wrong side of" - Ogden Nash
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.
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.
Actually, as far as classes of addicts, wireheads would be the easiest to deal with. There is no illegal supply chains for the trafficers to maintain. No one needs to be killed over a few miliamps of electricity. And the wireheads tended to conveniently remove themselves from society, and wither away in privacy, starving themselves to death in a state of bliss. Compare with heroin, crack, meth. converting all our addicts to this would be a boon to society.
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.
This wouldn't be used to treat those people, though. This is a severe measure which would be used to treat people who have actual, chemical things wrong with them, who despite having EVERYTHING in their life going right, can still be thinking about suicide.
Anybody who's known someone with REAL depression knows that it can be completely non-situational.
I find this theory to be extremely lacking. People don't think this way when it comes to treatments for heart disease, diabetes and things like that. Sure, some people should exercise more and lose weight to address their health issues, but there are some people that live unbelievably healthy lifestyles and still suffer from those type of ailments. Their bodies just don't respond to stimulus the right way.
I do not know why people insist the brain is any different just because we "think" with it. There is no reason to expect that the brain has some special property about it whereby it is incapable of a fundamental structural physiological problem that can manifest itself in negative ways such as depression. Just as someone who is born full blown type 1 diabetic could never produce insulin without some type of surgical intervention, it is logical to expect that there are people born with physical problems with their brain that will prevent them from ever being completely normal regardless of how much of a mental effort they put forth.
Just my $0.02.
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
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