Deep Brain Stimulation for Depression in Adults
Deep brain stimulation works like a pacemaker, but it’s used in the brain instead of in the heart. This technique requires surgically placing a small conductor, called an electrode, permanently in the brain. The electrode delivers a low level impulse that aids in regulating mood.
This experimental procedure is appropriate only for people with severe depression whose symptoms do not respond to medication. Although the U.S. Food and Drug Administration has not approved deep brain stimulation for the treatment of depression, several clinical studies have shown that it can be used safely and effectively.
NYU Langone neurosurgeons at the Center for Neuromodulation perform more than 100 deep brain stimulation procedures each year and are actively conducting research into the technique. Our neurologists, neurosurgeons, and psychiatrists perform a thorough evaluation to choose the best candidates for this procedure.
Surgery to Implant the Deep Brain Stimulation Device
Before the electrode is implanted into the brain, a neurosurgeon uses imaging tests, such as MRI or CT scans of the brain, to determine where it should be placed. To implant the device, the surgeon makes a small opening in the skull and inserts a thin, insulated wire with electrodes at the tip. He or she passes the wire under the skin of the head, neck, and shoulder.
Surgery to implant the electrode takes about four hours. It requires general anesthesia and an overnight hospital stay. The next day, the doctor performs a second surgery to connect the wires to a pulse generator, which is a small battery pack implanted under the skin near the collarbone. Most people can return home later that day.
Several days after surgery, the neurologist programs the pulse generator. You are able to control the electrical impulses with an external remote control.
People who use deep brain stimulation are able to control the strength of the electrical impulses after working with a neurologist to find the combination of settings that best controls their symptoms. After this adjustment period, most people require only occasional maintenance visits.
Many people choose to use the deep brain stimulation system 24 hours a day. The technique can significantly improve the lives of people who have depression that isn’t managed well by other therapies.