Implanted electrodes pick up a pattern of brain waves that can signal the presence or absence of depression and perhaps predict its relapse
On February 4, 2019, before he was wheeled into the operating room, Tyler Hajjar, then age 28, hugged his mother and quipped, “It’s just brain surgery.” Hajjar, a resident of Johns Creek, Ga., had traveled to Emory University in Atlanta to outfit his brain with a device that might reset it in hopes of easing the depression that had severely diminished his quality of life—and, at times, threatened that life—for a decade.
The results, reported on September 20 in Nature, reveal a neural code that represents the first known signal of the presence or absence of depression in the brain. “This is to me, studying depression for more than 30 years, the closest clue to know, fundamentally, ‘What is depression, and how do we think about how the brain can be repaired?’” says Helen Mayberg, a neurologist at the Icahn School of Medicine at Mount Sinai, who was co-senior author of the study.
The subcallosal cingulate, also known as “Brodmann area 25,” is embedded deep in the brain, above and behind the eyes. It is a critical crossroads for four major nerve fiber tracts and thus an intersection of brain traffic coming from areas that control all the functions that go awry in depression—emotional regulation, sleep, appetite, reward, motivation and memory, among others.
It was a promising sign. Over the course of six months, the device collected data from Hajjar’s brain and picked up a constellation of brain waves that reflected the combined activity of thousands of neurons. “Like a symphony where you have some high-pitched instruments and some low-pitched instruments, we can take these brain signals and decompose them into frequencies in different ranges,” Rozell says.
The sixth participant with usable brain data showed an atypical trajectory after treatment. She felt better after the operation and stayed well for four months, but then she relapsed. The scientists looked for the wellness signal in her after the fact. She had it at the start of her treatment, but it disappeared a month before she relapsed—and so it could have served as a warning sign. “If we would have had it, we would have turned up [her stimulation] a month earlier.
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