Trying brain pacemakers to zap psychiatric disease

Call them brain pacemakers, tiny implants that hold promise for fighting tough psychiatric diseases — if scientists can figure out just where in all that gray matter to put them.

Deep brain stimulation, or DBS, has proved a powerful way to block the tremors of Parkinson’s disease. Blocking mental illness isn’t nearly as easy a task.

But a push is on to expand research into how well these brain stimulators tackle the most severe cases of depression, obsessive-compulsive disorder and Tourette’s syndrome — to know best how to use them before too many doctors and patients clamor to try.

“It’s not a light switch,” cautions Dr. Michael Okun of the University of Florida.

Unlike with tremor patients, the psychiatric patients who respond to DBS tend to improve gradually, sometimes to their frustration.

And just because the tics of Tourette’s fade or depression lightens doesn’t mean patients can abandon traditional therapy. They also need help learning to function much as recipients of hip replacements undergo physical therapy, says Dr. Helen Mayberg of Emory University.

“Once your brain is returned to you, now you have to learn to use it,” she told the annual meeting of the American Association for the Advancement of Science.

Roughly 70,000 people around the world have undergone deep brain stimulation for Parkinson’s or other movement disorders when standard medications fail, says Okun, among leading researchers who gathered at that meeting last week to assess the field.

How does it work? Surgeons implant a wire deep in the brain. Tiny electrical jolts — running from a pacemaker-like generator near the collarbone up the neck to that electrode — disable overactive nerve cells to curb the shaking.

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