Currently, neurosurgeon Dr. Emad Eskander and his collaborator, psychiatrist Darin Dougherty, are using the technology to treat patients with severe obsessive-compulsive disorder (OCD). As part of the procedure, 42 centimeter-long electrodes are first implanted in the brain. Several days later a battery and pulse generator device is implanted under the skin either in the chest or abdomen, sending an electrical current that stimulates neural fibers in areas of the brain associated with motivation to the frontal lobe. In about half of the cases, the obsessions and compulsions begin to fade, then disappear, MIT Technology Review reported. About 2.5 million people in the U.S. suffer from OCD. Only the patients who have exhausted all other treatment options qualify for the surgery.
“DBS allows us to go into the actual circuit that we know is involved in a condition, and we’re stimulating it and making it fire or not fire in the way that we want it to,” Dougherty told the publication. “It’s night and day in terms of the robustness.”
Also working on the team are engineers at the Draper Laboratory who have come up with a prototype DBS system that will be able to record signals from hundreds of sites deep in the brain, and on its surface. Those signals will be used to create a pattern recognition software that can detect brain activity associated with pathological mental disorders that then trigger the electrical stimulation. The team hopes to begin testing the device on humans in 2016.
Although DBS technology has been around for almost 20 years–and has been used to treat patients with Parkinson’s, and the few with severe OCD–Eskander and Dougherty are hoping to expand that number (estimated at about 125,000) to include others who suffer from depression, PTSD, schizophrenia, borderline personality disorder and traumatic head injuries. The two physicians are co-leading a team on a 5-year, $30 million project that is part of President Obama’s BRAIN Initiative.
Still, OCD is the only psychiatric disorder for which the device is FDA-approved and only as a last-resort option. And Eskander understands that with only a 50% success rate using DBS for OCD, treating other mental disorders with the device remains a long shot. “Think about what’s happened over the past 20 years in terms of miniaturization … and everything,” Eskander said. “You have this device that came out in the 90s. When it was designed in the 1980s, I didn’t even have a cell phone.”
REFERENCE: Fierce Medical Devices; 12 OCT 2015; Joseph Keenan