• A brain implant has successfully treated severe depression in a US patient following a 15-month trial.
  • The implant uses deep brain stimulation (DBS) to trigger electrical charges that reset brain function.
  • It has the potential to revolutionize treatment for millions of people worldwide.

Typically characterized by prolonged periods of extreme low mood, other symptoms of depressive illness include: feelings of hopelessness, low self-esteem, a lack of motivation or interest in things and an absence of enjoyment from life.

It can be successfully treated with a range of therapies, from counselling to medication, and can be helped by changes in lifestyle. But for many people, depression can become a life-long struggle.

Now a scientific breakthrough could offer a solution for those with treatment-resistant depression.

this graph showing the prevalence of depression in different areas of the world highlights the fact that this disease is a global health problem.
Depression is a global health problem.
Image: World Health Organization

A pacemaker for the brain

US researchers and clinicians at the University of California San Francisco (UCSF) have developed an alternative to traditional approaches to treating depression – an implant that acts like a pacemaker for the brain.

It has so far been tested on one patient – with positive results.

We’ve developed a precision-medicine approach that has successfully managed our patient’s treatment-resistant depression by identifying and modulating the circuit in her brain that’s uniquely associated with her symptoms,” said Dr Andrew Krystal, Professor of Psychiatry at the UCSF Weill Institute for Neurosciences and senior author of the study.

How does it work?

The implant is embedded in the skull and wired to the patient’s brain.

The device UCSF has developed uses deep brain stimulation (DBS) to trigger electrical charges that reset brain function for the patient.

There are two electrodes implanted in the patient’s brain: one monitors neural circuits to detect changes in brain function that are associated with depressive episodes. The other can deliver a tiny electrical charge (one milliampere for six seconds) to adjust brain activity and – it is hoped – ease the bout of depression.

a diagram showing how personalized deep brain stimulation has relieved one patient’s depression.
Personalized deep brain stimulation has relieved one patient’s depression.
Image: UCSF

Depression can affect activity in different areas of the brain. Traditionally, DBS devices have only been able to deliver a constant trickle-charge to one brain area. The UCSF implant, however, can monitor a patient’s brain and react only when needed.

The UCSF team have run a 15-month trial of the device with a patient who they refer to as Sarah.

An amazing blessing

“I was at the end of the line,” said Sarah, of life before the implant. “I was severely depressed. I could not see myself continuing if this was all I’d be able to do, if I could never move beyond this. It was not a life worth living.”

Studies at UCSF had identified distinct patterns of brain activity that were affected by a patient’s mood changes. The discovery of this biomarker meant it was possible to develop treatments that would stimulate the brain to relieve depression in ways that were tailored to specific patients.

What is the World Economic Forum doing about mental health?

One in four people will experience mental illness in their lives, costing the global economy an estimated $6 trillion by 2030.

Mental ill-health is the leading cause of disability and poor life outcomes in young people aged 10–24 years, contributing up to 45% of the overall burden of disease in this age-group. Yet globally, young people have the worst access to youth mental health care within the lifespan and across all the stages of illness (particularly during the early stages).

In response, the Forum has launched a global dialogue series to discuss the ideas, tools and architecture in which public and private stakeholders can build an ecosystem for health promotion and disease management on mental health.

One of the current key priorities is to support global efforts toward mental health outcomes - promoting key recommendations toward achieving the global targets on mental health, such as the WHO Knowledge-Action-Portal and the Countdown Global Mental Health

Read more about the work of our Platform for Shaping the Future of Health and Healthcare, and contact us to get involved.

The implanted electrodes in Sarah’s brain could therefore be targeted precisely where they would be most effective.

The result was “a rapid and sustained improvement in depression,” the study authors said. The patient had an almost immediate alleviation of symptoms, she reported, which then lasted throughout the duration of the trial.

“For me, the device has been an amazing blessing,” said Sarah.

Two further patients have been enrolled in the trial, with the team hoping to add nine more in time.