Thursday, October 31, 2019

More Information On The DBS Study In Which I May Take Part

As I mentioned in my last blog post, I have not been getting any positive benefits from the Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) that I had last November.  If this trend continues until I have my 12 month follow-up appointment at the end of November, then I will be considered as a candidate for a Deep Brain Stimulation (DBS) trial that my neurosurgeon is leading.  DBS is a much more invasive procedure as it involves the insertion of electrodes in the brain and the placement of a battery pack just below the collarbone.  The electrodes stimulate a certain part of the brain and they have gotten some good results for people with treatment resistant depression.

A couple of days ago my 12 month follow-up appointments were scheduled and as part of that I will also have a DBS consultation with my neurosurgeon.  Thus, I received a consent form for the study in which I would take part.  The study is called "Deep brain stimulation of the medial forebrain bundle for the treatment of treatment resistant depression."  The document has some very interesting information about DBS and the study that they are doing.  Thus far, they have been able to achieve about a 50% success rate in people for which nothing else worked.  They achieved this success rate by primarily targeting an area of the brain called the subgenual cingulate cortex, also known as Brodman area 25.  This study will not target that area however.  This study will target an area of the brain known as the medial forebrain bundle (MFB).  The MFB is a part of the brain's reward system and is involved in the integration of reward and pleasure, so it seems like a good place to target.  Recently, in Germany, they did a study targeting this area of the brain and 4 out of the 5 participants noticed an improvement after 7 days and they were able to maintain that improvement.  Now, this is a very small sample size, but the results are encouraging.  My neurosurgeon is attempting to replicate these results and determine if this is a good area of the brain to target.

So, if I am accepted into this research study I would receive DBS, but in a different area of the brain than most people that have had DBS for depression have had.  It makes it a little bit more scary, because not only do they have to drill into my head to insert the electrodes into my brain, but they are doing it into an area that they have not done much before.  Like I said, the initial results are encouraging, but this is certainly a new procedure that is being done.  I am quite scared about it all,  but I feel like I need to continue to do whatever it takes to get better.  The life that I am currently leading is not a good one.

As an example of how my depression negatively effects my life, just over a month ago my father passed away.  He had been sick for a while, but we thought that he would get better and his death was quite unexpected.  I was certainly sad about his passing, but I have felt over the past month that my depression has been overshadowing my grief for the loss of my father.  I feel that I have not been able to properly grieve because I constantly feel the depression instead.  There are times that I feel the grief break through, but primarily I just feel depression.  This is just my experience.  Other people going through grief while experiencing depression might have different experiences.

So, for now I am going to continue with my plan to try and have the DBS surgery.  It is a scary surgery and I would be going into uncharted territory, but I cannot continue like I am.