2020 BSJ Blog Fall 2020

Deep brain stimulation: a potential new treatment for schizophrenia

By Andrea He

Schizophrenia is a severe disease that affects 1% of the worldwide population and reliable, effective treatments are almost nonexistent. Symptoms of hallucinations and delusions mark this mental disorder, changing the lives of patients and their families. However, a new treatment using the deep brain stimulation technique could improve the condition of patients.

Concerningly, 30% of people with schizophrenia do not respond to the lifelong antipsychotic medication prescribed to patients as reported by Dr. Helio Elkis in 2007 in his research paper “Treatment-Resistant Schizophrenia”. Antipsychotics are the cornerstone of schizophrenia treatments in order to alleviate symptoms. Patients often take these medications along with a combination of psychotherapy and even electroconvulsive therapy. The growing population of people with treatment-resistant schizophrenia is troubling; however, results from a new research study involving deep brain stimulation (DBS) could fix this problem, especially as structural changes in the brain are the potential cause of schizophrenia. 

DBS is a well-established and effective treatment that has been around since the late 1990s. By sending electrical impulses through electrodes implanted in the brain, it can change brain activity, making it a very appealing and potential treatment for schizophrenia. 

In 2019, researchers from the Centro de Investigación Biomédica en Red de Salud Mental in Spain tested DBS on schizophrenia patients who have been resistant to treatment. They attached electrodes to the ventral striatum and the subgenual anterior cingulate cortex, areas of the brain associated with schizophrenic symptoms. By activating the neurons, the electrodes attempted to correct neural networks in the brain and overcome neural abnormalities that characterize schizophrenia. After evaluating patients’ symptoms over the course of a year, the researchers concluded that four out of the seven patients had improved symptoms, which again worsened after the discontinuation of DBS—a statistically significant and very promising result. However, it is important to know that these results were considered of limited value due to the small sample size and variable endpoint criteria. 

Those researchers are currently working on larger trials with more patients in order for the treatment to be approved for clinical use. This research is a hopeful outcome for people who suffer from schizophrenia and can potentially help many live a normal life without the dangers of delusions and hallucinations. As treatment-resistant diseases become more common, more research will be needed in discovering new, innovative ways to treat disease.

References:

Corripio, I., Roldán, A., Sarró, S., McKenna, P. J., Alonso-Solís, A., Rabella, M., Díaz, A., Puigdemont, D., Pérez-Solà, V., Álvarez, E., Arévalo, A., Padilla, P. P., Ruiz-Idiago, J. M., Rodríguez, R., Molet, J., Pomarol-Clotet, E., & Portella, M. J. (2020). Deep brain stimulation in treatment resistant schizophrenia: A pilot randomized cross-over clinical trial. EBioMedicine, 51, 102568. https://doi.org/10.1016/j.ebiom.2019.11.029

Elkis, H. (2007). Treatment-resistant schizophrenia. Psychiatric Clinics, 30(3), 511–533. https://doi.org/10.1016/j.psc.2007.04.001

Lally, J., Gaughran, F., Timms, P., & Curran, S. R. (2016). Treatment-resistant schizophrenia: Current insights on the pharmacogenomics of antipsychotics. Pharmacogenomics and Personalized Medicine, 9, 117–129. https://doi.org/10.2147/PGPM.S115741