(CNN)After years of suffering, a patient with severe and untreatable depression has finally found relief with an experimental brain implant originally developed to help people with epilepsy, researchers in California reported Monday.

（美国有线电视新闻网，Cable News Network，简称CNN）加利福尼亚的研究人员在周一的报道中称，一名患者多年来患有严重且无法治疗的抑郁症。研究人员对其脑部植入一种试验性的植入物后，患者的病情得到了缓解。这种植入物最初是用于治疗癫痫患者的。

It's only a single patient, but the team at the University of California San Francisco says it has seen remarkable results with the device, which is calibrated to detect the signals associated with depressive symptoms in the patient's brain, and interfere with them.

虽然只有这一个病例，但是加州大学旧金山分校（University of California San Francisco，简称UCSF）的研究小组说，这种装置经过校准，能够有效地检出并干扰患者大脑中与抑郁症状相关的信号。

"When we turned this treatment on, our patient's depression symptoms dissolved and in a remarkably small time she went into remission," Dr. Katherine Scangos, a psychiatrist and neuroscience specialist at UCSF who led the study team, told reporters.

带领这个研究小组的是UCSF的精神病学家和神经科学专家凯瑟琳·斯坎戈斯（Katherine Scangos）博士，她告诉记者：“当我们采用这种治疗方法时，病人的抑郁症状消失了，并且病情很快得到了缓解。”

"It was like a switch."

“它就像一个开关。”

One year later the patient, who is identified only as Sarah, says the device has banished her depression with no side-effects.

一年后，患者（唯一代号Sarah）说这个装置治好了她的抑郁症，并且没有副作用。

"I had exhausted all possible treatment options with no success at lifting the depression that had descended five years earlier," Sarah told reporters.

Sarah告诉记者：“五年多以来，我用尽了各种可能的治疗方法，但是都不能够治疗我的抑郁症”

"My daily life had become so restricted and impoverished by depression that I felt tortured by each day and forced myself to resist the suicidal impulses that overtook me several times an hour. When I first received stimulation, I felt the most intensely joyous sensation," she added.

“因为抑郁症，我的日常生活已经开始受到限制，并逐渐变得贫穷。我每天都在遭受折磨，我必须努力地抑制突如其来的自杀冲动，这些冲动每个小时都会发生多次。当我第一次受到这个植入物的刺激时，那是我最快乐的时候。”她补充道。

"And my depression was a distant nightmare for a moment."

“我的抑郁症在一瞬间成为了一场遥远的噩梦。”


The study team worked intensely with Sarah to first map the areas of her brain that became active when she was experiencing the worst symptoms of depression. They implanted two small wires into her brain to detect the associated brain activity and then deliver a pulse of electricity that interrupts the signal.

研究组与Sarah合作密切。首先，当Sarah出现了最严重的抑郁症症状时，研究人员绘制出了她大脑活动的区域。他们将两根细电线植入她的大脑，检测到相关的大脑活动后，发送中断这些大脑活动的电脉冲。

It's a highly personalized treatment and one that will require years more of research to develop into anything that will be useful to the wider public, the team reported in the journal Nature Medicine.

这个研究组在《Nature Medicine》期刊上表示，这是一种高度个性化的治疗方法，还需要多年的研究才能发展成为普适有效的治疗方法。

But it provides some small hope for people with the most severe and intractable forms of depression, who are not helped by cognitive therapy, drugs or even electroconvulsive shock therapy, the team said.

但是研究组说，患有最严重和最棘手的抑郁症的人，不能进行认知疗法、药物甚至电休克疗法对疾病进行治疗。这个方法给他们带来了一些小小的希望。

"To identify a patient's unique depression circuit we placed temporary electrodes, which are really thin wires, into mood-related brain regions in patients with depression. And then we delivered small pulses of stimulation across the regions, one by one, and recorded the patient's clinical response," Scangos said.

“为了识别抑郁症患者独特的抑郁症回路，我们在患者与情绪相关的大脑区域放置了临时电极，这些电极都是非常细的电线。然后我们在各区域一个接一个地传递小脉冲刺激，并记录患者的临床反应。” 斯坎戈斯说道。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处


Other researchers have tried this approach for depression. According to the US National Institute of Mental Health, a review of various deep brain stimulation techniques shows that 40% to 50% of people treated with deep brain stimulation show more than 50% improvement. A different type of stimulation called vagus nerve stimulation is also being tested, as well as several techniques using magnetic stimulation of parts of the brain.

其他研究人员也尝试过这种治疗抑郁症的方法。据美国国家心理健康研究所（US National Institute of Mental Health，简称NIMH）称，回顾各种深部脑刺激（deep brain stimulation，简称DBS）技术，发现接受深部脑刺激治疗的患者中，40%到50%的人得到了50%以上的改善。

Precision mapping

精密制图

But Scangos and her colleagues said the difference on their approach was the careful mapping of Sarah's particular brain activity and the calibration of the device to respond to changes in signaling.

但是斯坎戈斯和她的同事表示，他们的方法的不同之处在于仔细绘制了Sarah特定的大脑活动图，为了响应信号变化，还对设备进行了校准。

"There is not one depression area or one mood area in the brain," said UCSF neurosurgeon Dr. Edward Chang, who was a member of the study team.

UCSF神经外科医生兼研究组成员Edward Chang表示， “大脑中没有抑郁区或情绪区。”

In Sarah's case, signals from the amygdala, a small structure in the brain associated with emotions, predicted her worst symptoms. Chang and colleagues adapted a commercially available device approved by the US Food and Drug Administration for treating severe epilepsy.

在Sarah的案例中，杏仁核（大脑中与情绪相关的一个小结构）发出的信号预告了她最严重的症状。Chang和他的同事采用了一种美国食品和药物管理局（US Food and Drug Administration，简称FDA）批准的商用设备来治疗严重癫痫。

"It affords us precision in a way that we never had before in treating depression. This is our first demonstration of personalizing," Chang said.

Chang表示，“这种方法使得我们能够准确地治疗抑郁症，虽然我们从未使用过这种方式来治疗抑郁症。这也是我们第一次进行个性化治疗。”

"The exact mechanism of how it treats the symptoms is unclear," he added. The team got the idea when they saw evidence that people being treated for epilepsy with the device often reported their symptoms of depression were improved by its use.

他补充道，“它治疗这些症状的确切机制尚不清楚”。研究组是受癫痫患者的启发想到这个治疗方法的。因为使用该设备治疗癫痫的患者经常汇报，他们的抑郁症状因使用这个设备得到了改善。

"The is not a demonstration of the efficacy of this approach. We have a lot of work ahead of us as a field to validate these results, to see if this is something that will be enduring as a treatment option," Chang said.

“这并不能证明这种治疗方法的有效性。为了验证这些结果，以及判断这种方法是否可以作为一种长期的治疗方案，我们还有许多工作要做。”Chang说道。

Sarah has the device permanently implanted now. A small piece of her skull was removed to accommodate the device, which is about the size of a matchbook, Chang said.

Sarah现在已经永久植入了这个装置。Chang说，为了装下这个火柴盒大小的装置，她取下了一小块头骨。

Scangos said Sarah receives about 30 minutes of stimulation on and off in a day to control her symptoms. The battery in the device should last about 10 years at this rate of use, she said. "We titrated the stimulation so she cannot detect it," Scangos said,

斯坎戈斯表示，Sarah每天接受大约30分钟的断断续续的刺激来控制症状。以这种使用率，设备中的电池能使用大概10年。“我们对刺激进行了滴定，所以Sarah无法感受到装置发出的刺激。”

Such an approach is only for the most severe cases, Scangos and Chang said.

斯坎戈斯和Chang表示，这种治疗方法只适用于最严重的情况。

"We didn't know if we were going to be able to treat her depression at all because it was so severe," Scangos said.

“Sarah的病太严重了，我们并不知道能否将她的抑郁症彻底治愈。”斯坎戈斯说。

"Even though this is what we call minimally invasive, it is surgery and it does have risks," Chang added.

“尽管这是我们所说的微创手术，但这是一种手术，是确实存在风险的”。Chang补充道。

'This joyous feeling washed over me'

‘这种快乐的感觉包围着我’


For Sarah, the effects were worth the risks. "Any kind of release would have been better than what I was experiencing," she said. "Depression controlled my life. I barely moved. I barely did anything."

对Sarah来说，治疗方法带来的疗效是值得冒险的。她说，“任何形式的解脱都好过我所经历的。那时抑郁症控制了我的生活，我无法行动，我无能为力。”

The first time the team tried the stimulation after mapping her brain, "I just laughed out loud," Sarah said.

研究小组在绘制了她的大脑图后第一次尝试采用这种刺激疗法。Sarah说道，“我只是大声笑了出来。”

"It was the first time I had spontaneously laughed and smiled where it wasn't faked, it wasn't forced, for five years," she added. "This joyous feeling washed over me."

“这是我五年来第一次在不虚伪的、真诚的地方自发地大笑和微笑。这种快乐的感觉包围着我。”她补充道。

It took considerable adjustment to make the stimulation feel seamless -- and to make sure the effects lasted for longer than a few minutes.

为了使得这种刺激连续不停顿，并确保效果持续几分钟以上，研究组还需要对这种治疗方法进行大量调整。

"At first, within a few weeks, the suicidal thoughts just disappeared. Then it was just a gradual process. It was like my lens on the world changed," Sarah said.

Sarah说，“起初，自杀念头在几周内就消失了。那是一个渐进的过程，仿佛我对世界的看法发生了变化，”

"Everything has gotten easier and easier and easier."

“一切事物变得越来越简单。”

One day sticks in her mind. "I just remember coming home one of the first times the device was on. I could see the bay and where it met the marshes, and I remember being, god -- like, the color differentiation. It's gorgeous -- the light." Sarah's depression symptoms had made the world seem gray and uninteresting.

她对其中一天记忆犹新。“我只记得，当我第一次开启治疗设备回到家的时候，上帝啊，我看到海湾和它与沼泽的交汇处，光彩夺目，灯烛辉煌。” Sarah的抑郁症状曾让世界变得灰暗乏味。

Not a moral failing

这不是道德上的缺陷

"By the end of this, I said oh my god -- this is no different from someone with Parkinson's," Sarah said.

“最后，我说，天哪，这和帕金森病患者没什么不同。” Sarah说道。

"Nobody says to somebody with Parkinson's 'if you just have a positive attitude and bear up, you'll cure yourself.' No one says this to someone with cancer,' " she added. But people do not treat depression as a disease, she said.

Sarah补充说，“没有人对帕金森病患者和癌症患者说‘只要你有积极的态度并坚持下去，你就能治愈自己。’。但人们并不把抑郁症视作一种疾病。”

"The feedback we get from society is it is a moral failing. It must be something that you are doing wrong," she said. "Even if it is well meaning."

“社会给我们的反馈是，抑郁症是一种道德败坏，一定是你做错了什么事。”Sarah说道。“虽然这种反馈是出于好心的，并无恶意。”

Every failed treatment made her feel more like a failure, Sarah said. "The stigma of depression is an overwhelming weight," she said.

每一次失败的治疗都让她觉得自己是个失败者，Sarah说，“抑郁症带来了巨大的耻辱感。”

According to NIMH, depression is characterized by a persistent feeling of emptiness and guilt, loss of hope and energy and other symptoms. "Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors," NIMH says.

据NIMH称，抑郁症的特点是持续地感到空虚和内疚，失去希望和精力以及其他症状。NIMH表示，“抑郁症是美国最常见的精神疾病之一。目前的研究表明，抑郁症是由遗传、生物、环境和心理因素共同引起的。”

About 5% of people worldwide suffer from depression, according to the World Health Organization.

根据世界卫生组织（World Health Organization，简称WHO）的数据，世界上约5%的人患有抑郁症。