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New Neurosurgery Treatment for Severe Depression


Severe depression is a challenge to treat, and now a new neurosurgical treatment approach has been found that may help those who suffer with this debilitating condition. The new treatment involves a variation of a neurosurgery technique developed at Frenchay Hospital in Bristol, UK.

First patient responds to new neurosurgery approach

A research team at the University of Bristol and North Bristol NHS Trust reported on their success with the first patient to undergo the new treatment, 62-year-old Sheila Cook. Ms. Cook had suffered with severe depression for more than ten years, had attempted suicide at least once, and had not responded to other treatment attempts.

In past years, Cook stopped responding to conventional treatment for severe depression, which prompted the use of deep brain stimulation. This therapeutic approach involves delivery of brief electrical energy via electrodes implanted in the brain. She participated in the first-ever trial that stimulated two different brain networks known to be involved in depression.

After temporary improvement, Cook relapsed, and she underwent an advanced stereotactic neurosurgical technique in early 2010. The technique involves the use of implantable guide tubes and is a new variation of a surgical approach called anterior cingulotomy, which is already recognized for treatment of severe depression.

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The new neurosurgical approach is much more accurate than conventional anterior cingulotomy alone. Basically, the specially developed surgical approach involves implanting guide tubes, and the procedure modifies circuitry in the brain that is important in emotion and appears to be overactive in some psychiatric disorders.

According to Dr. Andrea Malizia, one of the research team leaders and a consultant senior lecturer in the School of Social and Community Medicine at the University of Bristol, “This lady responded temporarily to two of the complex treatments that we initiated in Bristol, but in the end remission has only been achieved by persisting and moving on to the next advanced treatment.”

According to North Bristol NHS Trust, chronic depression is severely disabling, and about 15 percent of people who suffer with the disease die by suicide. Previous research has shown that some antidepressants may work for people who have very severe depression while offering little or no relief for those with mild to severe depression. However, in Cook’s case, as in others, the medications did not work.

A story about Ms. Cook and the new neurosurgery treatment for severe depression appeared on Inside Out West on BBC ONE on January 24, 2011. For her, the new technique was a life saver. “I cannot thank the clinicians and researchers who worked with me enough—they have given me my life back.”

Fournier JC et al. JAMA 2010 Jan 6; 303(1): 47-53
North Bristol NHS Trust