Parkinson's treatment offers depression clues
NEW YORK, May 12, 1999 (Reuters Health) -- While using a new technique
to treat a patient with advanced Parkinson's disease, scientists in
France have discovered a region of the brain that appears to play an
important role in depression.
Stimulation of electrodes implanted in the part of the brain known as
the basal ganglia is being used to treat some patients with advanced
Parkinson's disease. The researchers noted that one female patient began
to cry and feel despondent when a specific area of her brain was
electrically stimulated. As soon as the electrical stimulation stopped,
the woman was happy and laughing again within a minute or two, according
to a report in the May 13th issue of The New England Journal of
Medicine.
Dr. Boulos-Paul Bejjani and other physicians at the Hopital
Pitie-Salpetriere in Paris, France, planted tiny wires deep within the
woman's brain as part of the promising new treatment.
After the surgery, the doctors found that stimulation of two of the
areas resulted in improvement in the woman's symptoms, to the extent
that her medications were discontinued one month after surgery.
But when they stimulated one particular electrode, according to the
report, ``the patient leaned to the right, started to cry, and verbally
communicated feelings of sadness, guilt, uselessness, and
hopelessness.'' Less than 90 seconds after the stimulation ended, her
feelings of depression disappeared.
The investigators note that the woman had no history of depression or
any other psychiatric disorder.
Because the area affected by the pulses is so small -- only a few cubic
millimeters -- the authors speculated that they had temporarily
stimulated nerve pathways important in the processing of unpleasant
feelings.
``Our findings,'' they write, ``provide a basis for further studies to
elucidate the neural networks involved in depression.''
``This observation confirms the potential involvement of neural networks
in some depressive states,'' said one of the team, Dr. Philippe Damier,
in an interview with Reuters Health. ''In the future, we could imagine
being able to modulate (in another way) some neural network to treat
some (forms of) severe depression.''
Damier also expressed the hope that their observation would not damage
the prospects for deep-brain stimulation as a treatment for Parkinson's
disease.
``This patient is currently doing perfectly well with no need for any
drug treatment,'' he said, ``and indeed with no depressive mood, since
the contacts used chronically to correct her Parkinson's disease are
perfectly placed.''
SOURCE: The New England Journal of Medicine 1999;340:1476-1480.
Copyright © 1999 Reuters Limited.
--
Judith Richards, London, Ontario, Canada
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