Surgery for Depression is Possible!!!!

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Radical new neurosurgical treatment that accurately targets brain networks involved in depression is being pioneered for the first time in the world at Frenchay Hospital in the city of Bristol in the UK.

The new treatment includes experimental antidepressants, deep brain stimulation and stereotactic neurosurgery, and the research team at the University of Bristol and North Bristol NHS Trust hope it will help people suffering with severe and intractable depression.

The first patient to receive the treatment is 62-year-old grandmother Sheila Cook from Torquay. She had been fighting a long hard battle with depression for more than a decade, and has tried to commit suicide more than once in that time.

North Bristol NHS Trust reported in a statement on Monday that Cook is beginning “to enjoy life again”. She said her life has changed and she feels happy for the first time in years.

The research team has two leaders, Dr Andrea Malizia, a Consultant Senior Lecturer in the School of Social and Community Medicine at the University of Bristol, and Mr Nikunj Patel, a Senior Clinical Lecturer in the Department of Neurosurgery at North Bristol NHS Trust.

Cook’s illness had stopped responding to conventional treatments when she was offered deep brain stimulation and to undergo the first trial in the world to stimulate two different brain networks involved in depression.

But the deep brain stimulation only resulted in a temporary response, and was not sufficient to make her well. However, following further advanced stereotactic neurosurgery in early 2010, she is now well, said the Trust.

Cook’s story was covered in the BBC 1 television program “Inside Out West”, broadcast in the evening of Monday 24 January.

Deep brain stimulation is where electrodes connected via thin wires to a “pacemaker” are inserted deep in the brain via holes drilled in the skull.

By delivering short bursts of electricity, the electrodes stimulate or inhibit brain circuits specific to the condition being treated. In this case, the circuits targeted are relevant to depression and are thought to regulate internal drives, monitor emotion, and help control the integration of emotion with bodily and intellectual function.

Deep brain stimulation does not work in every case and some patients just aren’t suitable for it.

However, an alternative method specifically developed at Frenchay, which Cook is the first patient to receive, is a surgical procedure called “Anterior Cingulotomy“, using implantable guide tubes.

While anterior cingulotomy, which removes the anterior cingulate cortex as well as the fibers of the cingulum, is already a recognized neurosurgical procedure for severe depression, the approach developed at Frenchay is much more accurate.

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