Good. The more of this junk science gets shot down the better. Let's see more of these articles rather than the ones about miraculous new inventions to cure cancer/Alzheimers/diabetes/insert your favorite disease. The carelessness with which these findings are shot into the world and the amount of press they get before there is even a proper chance to evaluate the findings, to review the experimental setup and possible biases and to replicate the results is very annoying. Not a day goes by without an announcement of that kind, the number of times I've seen 'cure for X' in the headline of some article that then later gets retracted (usually very quietly) is depressing. Maybe I should get some deep-brain-stimulation to counteract that effect.
It's science(and I can say this knowing the researchers). The trials were done rigorously and according to regulatory requirements. The results may be negative, but they are valid results.
What it means for depression and DBS down the line remains to be seen. I agree w/ the poster below that a lot may depend on how you define depression; one critique may be that surgical candidates were not all suffering from the type of depression affecting the subcallosal cingulate area.
Of course the rationale for actually implanting the devices in the subcallosal cingulate were based on PET and fMRI results; and many in the imaging field regard those techniques as "junk science" but that is an argument with many barbs and perhaps better saved for another day...
>The results may be negative, but they are valid results.
Except they were mostly (if not all) uncontrolled. Uncontrolled trials for depression are bad science, because the placebo effect has such a large effect. Even if an open-label trial for depression is successful, it tells you absolutely nothing.
The one cited in the link was controlled and blinded using sham stimulation in the group. The problem isn't that it wasn't controlled, it may not have been powered (n=30ish?) enough to reliably detect a difference...which is the main bugaboo in clinical science. Recruiting enough people into the study to make it meaningful is the hard and expensive part.
Depression itself is, I suspect, something rather like cancer—the underlying problems can come from many things, but the symptoms may appear to be similar.
ECT worked for me, but probably wouldn't work for everyone. Most treatments may be described like that—IMHO, the only universal treatment is therapy. This doesn't mean we should throw the rest of the treatments out the window. If the hammer works for the job, why look for a nailgun that doesn't exist?
> Do you have some confidence that the ECT worked for a reason other than placebo?
I found great relief from it that seemed distinctly different from before the ECT. I haven't found much reason to think about it more than that—I'm not in the business in prescribing treatment, but I'm grateful for what I did find. Sylvia Plath's The Bell Jar has an excellent description of the aftermath of the treatment that roughly aligned with my own, albeit I experienced it much slower than how it was depicted in the novel.
ECT is often seen as an archaic and barbaric treatment, but there is reasonably good evidence to suggest that it is an effective short-term treatment for severe depression. The question isn't really whether it works, but whether the benefits are worth the risk of side effects. That is largely a personal decision for a patient to make rather than a matter of public policy.
This isn't "junk science". DBS has been shown to have an antidepressant effect: http://www.sciencedirect.com/science/article/pii/S0896627305...
It can be compared to a support vector machine or FPGA in that it can be tuned easily to each patient's specific parameters. There have been successes and failures just as machine learning has had, and it all comes down to the parameters of stimulation.
I think you're confusing junk reporting with the science, which is solid (DBS is remarkably effective for treating motor disorders). It's unclear how effective it is for treating other issues, which is why studies like this are done!
The brain is a black box of complexity. Until we completely understand what's going on we don't even know if we're treating something that is even fixable. It's like adding random voltages to pins on a motherboard to try to fix a software bug.
Deep brain stimulation for Parkinson's is pretty incredible [1] and transcranial magnetic stimulation for depression is effective [2]. The open label studies on DBS for depression were promising, so it was perfectly reasonably to try it out in a randomized controlled trial.
DBS for Parkinson's (and dystonia and essential tremor) work reliably well, and the complication rates are considered acceptable. However, in terms of understanding the mechanisms of how they work on the brain, I would very much characterize it as a black box. So much so that if you look at the different ways different medical centers and practitioners program the devices, it's clear we don't know how it works; just that it does (and extremely effectively) once you fiddle around with the settings long enough.
I don't think anyone doubts the value of completely understanding what's going in the brain, but it's clear this is an insanely difficult task. It's incredibly difficult reverse engineering something as complex as the brain when we have little understanding of its capabilities and limitations unlike a digital computer. Until then, I don't see the problem with using various therapies to attempt to cure conditions. I definitely don't see the value in asking people who are suffering to wait until a seemingly unsurmountable task is completed.
Of course. Not all disorders can be treated with the blunt hacks we currently use though. I think depression is one of those things that can't be understood until we reverse engineer the brain.
Perhaps, because Depression is nothing but a set of acquired habits (self-conditioning) which could be un-learned/altered (through applying a CBT - systematic behavior change) by acquiring a different set of new habits.
