Home What is DBS? Technology Advances Mental Disorder Treatment Future Work References

Medtronic Case

Medtronic has recently reported on the largest and longest held clinical trial using its Activa DBS platform. It reported on the success of both treatment resistent depression and OCD.

• 26 patients with OCD were implanted with the system and follow ups were done up to 3 years later
• 17 patients with Major Depression who had previously underwent and failed multiple medical electroconvulsive therapy trials

The DBS treatment led to improvements in several depression tests, including the Hamilton Depression Rating Scale. Prior to this announcement, a study was published in Neuron presenting the results of Dr. Helen Mayberg's study using the Medtronic Soletra device. They published similar results praising the effectivness of DBS in a blind study. Stimulation parameters were varied from .06-.1 ms pulse width at 130Hz at potentials from 1 - 9V. This study also identified the area of the brain for stimulation, the subgenual cingulate region (or Brodmann area 25), that will be further investigated in clinical trials.

St. Jude Medical has progressed in treating severe mental disorders using their Libra system. It was granted a patent on the Broadmann Area 25, the cornerstone for the BROADEN study. The patent and this study will develop the DBS technology for severe, treatment-resistent depression.

Schematic depicting the Subgenual Cingulate and Orbital Cortex found through advanced imaging techniques such as PET and fMRI. [7]

With so much depending on locating the origin of the disturbance in the brain, imaging takes on a huge role in mainstreaming DBS. Having sound methods for consistently locating the exact area that is to affected by the implanted electrodes can be coupled with robotic technology to develop a reliable and safe procedure to implant the DBS system.