The appointment started out with some more psychiatric scales testing to set a baseline before I get the surgery that we can compare against as my mood improves, or not, over the next year. They are the same scales as I did for my Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS), so I can also compare how my mood is doing now against the last time I had the scales at my 12 month follow-up. All of the tests that I did while I was undergoing the MRgFUS study showed that I was suffering from severe depression. The first test that we did was the Hamilton Rating Scale for Depression (HAM-D). At my 12 month follow-up, I received a score of 25 on this test. Today I also received a score of 25, so there was no change with this score. Scores of greater than or equal to 23 indicate a very severe depression. The second test that I did was the Montgomery–Åsberg Depression Rating Scale (MADRS). At my 12 month follow-up I received a score of 38. Today I received a score of 44. Scores of greater than 34 indicate severe depression. So, my depression is getting worse according to this test. Finally I did the Beck Depression Inventory (BDI). At my 12 month follow-up my score was 39. Today my score was 41. Scores of greater than or equal to 29 indicate severe depression. Thus, I am also getting slightly worse according to this test. Overall, my scores seem to indicate that my depression is getting slightly worse.
Next I signed the consent forms indicating that I was willing to take part in this study. There was nothing much to report on this as I had already read the consent a few months ago. There is one thing of interest though that I neglected to mention in any of my previous blog posts. After I have had the device implanted for 6 months a blinded section of the trial will occur. The purpose of the trial is to give a better understanding of the possible benefits the DBS is having on my symptoms. The DBS will be turned off for 1 week. Then, I will be randomly assigned to have the DBS turned OFF for 2 weeks and then ON for 2 weeks, or the opposite order. I will be seen each week and they will test my mood to see if having it turned OFF or ON has an effect. I will not know if the device is turned OFF or ON, so I cannot influence the results.
After signing the consent, I had a functional MRI, or fMRI, performed. This is done in an MRI machine whose magnet is rated at 3 Teslas (a unit of measurement for magnets). Usually MRI machines are rated at 1.5 Teslas, so it is twice as strong as a usual machine. One of the reasons that they are doing the fMRI testing on a 3 Tesla MRI machine is that they want to prove that the DBS device is safe to use in 3 Tesla machines. They already know that it is safe to use in 1.5 Tesla machines, but they want to prove the same result for 3 Tesla machines. The tests that they have done show that the DBS device should heat up by no more than 1 degree Celsius in a 3 Tesla machine, but they have to do human trials, so I will be one of the test subjects. Hopefully nothing goes wrong!
While performing the fMRI they also want to get some information about how the brain works in people that haven't had a DBS device implanted versus those that have. Thus, I did some quizzes while in the MRI machine and they could tell how my brain was working while I was doing it. The first quiz involved showing me a series of pictures of beer and asking my how much I was craving alcohol followed by a series of random pictures and asking me the same question. They repeated this many times with pictures of beer and random pictures. The purpose of this was to get an idea of the reward pathways in the brain. They will repeat the test 3 times after I have the surgery. The next quiz involved showing me a face of a person with a particular emotion and then having to pick out the face of someone with a similar emotion from a set of two pictures. They would also show me a shape and then I would have to pick out a similar shape from a set of two pictures. This is just to see how the brain works in people without a DBS device inserted versus those that have. Again this will be repeated 3 times after I have had the surgery.
To close off this blog I'd like to post a video about getting DBS for depression that I have been thinking a lot about lately. The first line of this video is very meaningful to me.
As you're lying on the table you're wondering how you got to the point where holes drilled in your head sounds like a good idea.This is what I wonder.
No comments:
Post a Comment