(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."


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


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


"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.


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


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.


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.


"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。
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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


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.


"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.


"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.


"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.


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.


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,


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


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


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


'This joyous feeling washed over me'


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."


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


"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."


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


"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.


"Everything has gotten easier and easier and easier."


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


"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.


"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."


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


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.


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。