Current State of the UHN Deep Brain Stimulation (DBS) Clinical Trial

Deep brain stimulation (DBS) is currently the most powerful known treatment for major depression.  The technique itself was developed at the Toronto Western Hospital nearly 10 years ago.  It was based on research findings by neurologist Dr. Helen Mayberg, working with a multi-disciplinary team that included world-renowned neurosurgeon Dr. Andres Lozano, our own Clinic’s Co-Director, Dr. Peter Giacobbe, as well as UHN’s Psychiatrist-in-Chief, Dr. Sidney Kennedy.  Because DBS can often achieve remission where all other measures fail, the tecnhique is now being used to treat severe depression in advanced medical centres across Canada and around the world.

With DBS, a neurosurgeon implants a pair of electrodes into a small brain structure that is overactive in depression, called Area 25, or the subgenual cingulate.  The electrodes stimulate at a high frequency that effectively jams the signals passing through the neural connections in the region.  Once the electrodes are activated, many patients experience a rapid and dramatic improvement in symptoms — even patients who have not responded to any other treatment, including ECT.  However, DBS remains an experimental technique, available only to small numbers of patients, in medical centres with expert teams of neurosurgeons.  It also requires the electrodes to be permanently implanted in the brain and connected to a battery implanted under the collarbone — quite an invasive procedure compared to other treatments for depression.  For these reasons, DBS is usually reserved for cases where all other options have failed.