5 ms·

The first study of individualized brain stimulation to treat severe depression

84 points by ed 5y ago

hprotagonist 5y ago
more technical presser: https://www.fiercebiotech.com/medtech/ucsf-health-s-customized-pacemaker-for-brain-successfully-treats-severe-depression https://www.fiercebiotech.com/medtech/ucsf-health-s-customiz... The paper: https://www.nature.com/articles/s41591-021-01480-w https://www.nature.com/articles/s41591-021-01480-w
drawqrtz 5y ago
https://archive.vn/VDl10 https://archive.vn/VDl10
pgt 5y ago
If you simulate a depressed brain sufficiently accurately, are you prolonging the suffering of a depressed mind?
- drdeca 5y ago
  Stimulation, not simulation.
smitty1e 5y ago
Getting a Louis Wu vibe here: https://www.wireheading.com/wirehead.html https://www.wireheading.com/wirehead.html
concinds 5y ago
I'm glad this is helping some people, and I'm always in favor of treatments that help people who are "lost causes" (people with chronic illness and every treatment they tried so far has failed), but this stuff really creeps me out. There's that story of the Navy SEAL that developed mania and psychosis from excessive use of rTMS that was making the rounds a few years ago (https://rewired.inewsource.org/ucsd-kevin-murphy-prtms-navy-seals.html https://rewired.inewsource.org/ucsd-kevin-murphy-prtms-navy-...). It just seems like an example of scientists playing around with a complex system they have a very incomplete understanding of, with potentially risky outcomes. The brain isn't a heart, it's not just a matter of getting it "beating" at the right pace. With the Navy SEAL who went insane, the main problem seems to have been excessive treatment (rTMS worked at first, but the effects kept going away without more stimulation, so even though he was supposed to be "cured" after a few months and require no further treatment, he had essentially become "addicted" to brain stimulation). Brain stimulation implants seem too similar: meant to stimulate certain emotions in perpetuity, with nothing really addressing the underlying causes. Psychotropics are already suboptimal in that same sense (addressing symptoms, not root causes) but it seems like a safe bet that this will have more unintended effects than drugs. I don't want to discourage anyone here from getting treatment (as a sidenote, what worked for me for depression was internal family systems therapy, which is also pretty "out there" and cutting edge) but I'm wary that with more focus and funding for rTMS, there'll be less attention on finding more "root cause" solutions.
- hprotagonist 5y ago
  This is DBS, similar to therapies for motor disorders like Parkinson’s. It’s also invasive; a surgery is performed to implant an electrode into the striatum. rTMS is noninvasive and much less targeted. Based partly on motor disease research into disorders like Parkinson’s disease, there is a growing theory in the neurosciences that brain disrhythmic behavior is the root cause for a variety of disorders, with a plastic feedback loop on top that reinforces things as the disease progresses. Closed-loop stimulation that disturbs the maladaptive behavior when it starts works stunningly well for some motor diseases, and at least in one patient, for MDD as well.
  - concinds 5y ago
    Interesting, that makes me trust this quite a bit more. Regardless, this is bound to really contribute to our understanding of the brain, so I'm grateful for this research.
    - chofpsychiatry 5y ago
      Absolutely! Sometimes for treatment the person doesn't even have to be depressed![1] Its like all those animal rights activists who get their knickers in a knot when a child dissects his pet dog. Don't they know that while it's alive there's more to learn? [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_sectitle https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_... (edit: "While it's alive" could be interpreted as meaning not to engage in invasive, involuntary treatment at all, due to its riskiness. This was not the intention. There's a sweet spot in one's learning where a subject will yield any information one desires of it in its attempt to prevent the inevitable, as concinds implies.)
- maybelsyrup 5y ago
  Great comment. > but the effects kept going away without more stimulation, so even though he was supposed to be "cured" after a few months and require no further treatment This describes most mental health treatments, especially the drugs. > internal family systems therapy I'm a huge fan of this, too. Did wonders for my relationships. > that story of the Navy SEAL This is fascinating. Given what you read about these guys these days, needing serious professional help doesn't exactly surprise me.
AndrewBissell 5y ago
From the same newspaper in 1970: "Brain Researcher Jose Delgado Asks -- 'What Kind of Humans Would We Like to Construct?' ": https://www.nytimes.com/1970/11/15/archives/brain-researcher-jose-delgado-asks-what-kind-of-humans-would-we.html https://www.nytimes.com/1970/11/15/archives/brain-researcher...
echopurity 5y ago
A one person experiment? Zero mention of social factors of depression? 250 million people with depression just need their brain shocked regularly? Sounds right for HN.
stooliepidgin 5y ago
I'm having TMS done for 9 weeks starting at the end of this month for treatment-resistant, endogenous depression. Wish me luck. I'm considering doing a ketamine treatment too.
- fpgaminer 5y ago
  Best of luck to you! I hope everything goes well.
- hypersoar 5y ago
  Good luck! I went through a course of TMS last year and had pretty good results.
- chofpsychiatry 5y ago
  Congratulations! If one is feeling depressed despite simply doing what everyone else is doing, that shouldn't be a time to start asking questions. There is no need to think about the effect one's actions are having. There is no reason to feel guilty for participating in activities that are causing avoidable harm. There is no reason or need to change one's behavior. Drugs, not integrity, bring happiness. Drugs will give you salvation.
chofpsychiatry 5y ago
This is fantastic news. We don't know much about Sarah, but we do know this: She may not have given consent for this treatment; it may have been given by someone else on her behalf.[1] Her current disease has no objective tests.[2] Now if she wants to pursue the defence of her legal interests then oopsie! Looks like she's got a little remote-controlled electroshock device in the brainsie! We would like to thank the NY Times for publishing this article and the commenters on Hacker News for allowing the psychiatrists to continue pursuing these activities. Remember, it's not rape if you penetrate and deeply stimulate someone's brain directly! [1] https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140SB940 https://leginfo.legislature.ca.gov/faces/billTextClient.xhtm... [2] https://www.researchgate.net/publication/305338320_Seeking_an_objective_diagnosis_of_depression https://www.researchgate.net/publication/305338320_Seeking_a...

84 points by ed 5y ago

more technical presser: https://www.fiercebiotech.com/medtech/ucsf-health-s-customized-pacemaker-for-brain-successfully-treats-severe-depression https://www.fiercebiotech.com/medtech/ucsf-health-s-customiz... The paper: https://www.nature.com/articles/s41591-021-01480-w https://www.nature.com/articles/s41591-021-01480-w

drawqrtz 5y ago

https://archive.vn/VDl10 https://archive.vn/VDl10

pgt 5y ago

If you simulate a depressed brain sufficiently accurately, are you prolonging the suffering of a depressed mind?

drdeca 5y ago
Stimulation, not simulation.

smitty1e 5y ago

Getting a Louis Wu vibe here: https://www.wireheading.com/wirehead.html https://www.wireheading.com/wirehead.html

concinds 5y ago

I'm glad this is helping some people, and I'm always in favor of treatments that help people who are "lost causes" (people with chronic illness and every treatment they tried so far has failed), but this stuff really creeps me out. There's that story of the Navy SEAL that developed mania and psychosis from excessive use of rTMS that was making the rounds a few years ago (https://rewired.inewsource.org/ucsd-kevin-murphy-prtms-navy-seals.html https://rewired.inewsource.org/ucsd-kevin-murphy-prtms-navy-...). It just seems like an example of scientists playing around with a complex system they have a very incomplete understanding of, with potentially risky outcomes. The brain isn't a heart, it's not just a matter of getting it "beating" at the right pace. With the Navy SEAL who went insane, the main problem seems to have been excessive treatment (rTMS worked at first, but the effects kept going away without more stimulation, so even though he was supposed to be "cured" after a few months and require no further treatment, he had essentially become "addicted" to brain stimulation). Brain stimulation implants seem too similar: meant to stimulate certain emotions in perpetuity, with nothing really addressing the underlying causes. Psychotropics are already suboptimal in that same sense (addressing symptoms, not root causes) but it seems like a safe bet that this will have more unintended effects than drugs. I don't want to discourage anyone here from getting treatment (as a sidenote, what worked for me for depression was internal family systems therapy, which is also pretty "out there" and cutting edge) but I'm wary that with more focus and funding for rTMS, there'll be less attention on finding more "root cause" solutions.

hprotagonist 5y ago
This is DBS, similar to therapies for motor disorders like Parkinson’s. It’s also invasive; a surgery is performed to implant an electrode into the striatum. rTMS is noninvasive and much less targeted. Based partly on motor disease research into disorders like Parkinson’s disease, there is a growing theory in the neurosciences that brain disrhythmic behavior is the root cause for a variety of disorders, with a plastic feedback loop on top that reinforces things as the disease progresses. Closed-loop stimulation that disturbs the maladaptive behavior when it starts works stunningly well for some motor diseases, and at least in one patient, for MDD as well.
- concinds 5y ago
  Interesting, that makes me trust this quite a bit more. Regardless, this is bound to really contribute to our understanding of the brain, so I'm grateful for this research.
  - chofpsychiatry 5y ago
    Absolutely! Sometimes for treatment the person doesn't even have to be depressed![1] Its like all those animal rights activists who get their knickers in a knot when a child dissects his pet dog. Don't they know that while it's alive there's more to learn? [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_sectitle https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_... (edit: "While it's alive" could be interpreted as meaning not to engage in invasive, involuntary treatment at all, due to its riskiness. This was not the intention. There's a sweet spot in one's learning where a subject will yield any information one desires of it in its attempt to prevent the inevitable, as concinds implies.)
maybelsyrup 5y ago
Great comment. > but the effects kept going away without more stimulation, so even though he was supposed to be "cured" after a few months and require no further treatment This describes most mental health treatments, especially the drugs. > internal family systems therapy I'm a huge fan of this, too. Did wonders for my relationships. > that story of the Navy SEAL This is fascinating. Given what you read about these guys these days, needing serious professional help doesn't exactly surprise me.

AndrewBissell 5y ago

From the same newspaper in 1970: "Brain Researcher Jose Delgado Asks -- 'What Kind of Humans Would We Like to Construct?' ": https://www.nytimes.com/1970/11/15/archives/brain-researcher-jose-delgado-asks-what-kind-of-humans-would-we.html https://www.nytimes.com/1970/11/15/archives/brain-researcher...

echopurity 5y ago

A one person experiment? Zero mention of social factors of depression? 250 million people with depression just need their brain shocked regularly? Sounds right for HN.

stooliepidgin 5y ago

I'm having TMS done for 9 weeks starting at the end of this month for treatment-resistant, endogenous depression. Wish me luck. I'm considering doing a ketamine treatment too.

fpgaminer 5y ago
Best of luck to you! I hope everything goes well.
hypersoar 5y ago
Good luck! I went through a course of TMS last year and had pretty good results.
chofpsychiatry 5y ago
Congratulations! If one is feeling depressed despite simply doing what everyone else is doing, that shouldn't be a time to start asking questions. There is no need to think about the effect one's actions are having. There is no reason to feel guilty for participating in activities that are causing avoidable harm. There is no reason or need to change one's behavior. Drugs, not integrity, bring happiness. Drugs will give you salvation.

chofpsychiatry 5y ago

This is fantastic news. We don't know much about Sarah, but we do know this: She may not have given consent for this treatment; it may have been given by someone else on her behalf.[1] Her current disease has no objective tests.[2] Now if she wants to pursue the defence of her legal interests then oopsie! Looks like she's got a little remote-controlled electroshock device in the brainsie! We would like to thank the NY Times for publishing this article and the commenters on Hacker News for allowing the psychiatrists to continue pursuing these activities. Remember, it's not rape if you penetrate and deeply stimulate someone's brain directly! [1] https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140SB940 https://leginfo.legislature.ca.gov/faces/billTextClient.xhtm... [2] https://www.researchgate.net/publication/305338320_Seeking_an_objective_diagnosis_of_depression https://www.researchgate.net/publication/305338320_Seeking_a...