Brain Week 2022 in Monaco: electrostimulation against depression
A story that dates back some 2000 years! It is indeed Scribonius Largus, doctor of the Emperor Claudius who proposed treatments by animal electricity to treat gout and headaches. A Mediterranean torpedo fish was applied to the patient’s forehead, between the eyebrows, and discharged until the patient’s senses were numb, hence the name “torpor” for this condition.
In the XVIIIand century was perfected galvanism: it is then the beginning of electrophysiology.
“The electroshocks were very effective”
In psychiatry, electric shocks were invented in Italy in 1938. If they may seem barbaric because they trigger convulsive seizures, in connection with images such as those in the film One Flew Over the Cuckoo’s Nest with Jack Nicholson by example, they are still used today. But the current technique frees itself from somewhat traumatic clichés. “Violent images circulate around the electrostimulation until the execution of the condemned man, emphasizes Dr. David Szekely. However, we are no longer in this register today”reassure the doctor.
In the second part of the XXand century, “on a discovered neuroleptics and antidepressants, explains Dr. David Szekely. But since the 80s, we realized that electroshocks were very effective. It’s very codified.”
Neuromodulations increase or decrease the excitability of a group of neurons through an electrical stimulus. At a time when it is estimated that depression will become the leading cause of disability (it was the 2and until now), it is obviously essential to find the most effective therapies possible. “We are constantly having consultations for post-traumatic stress states. Finding other therapeutic avenues is a major challenge.”
Alongside drug treatments, neuromodulation techniques (based on electricity, magnetism, surgical or non-surgical procedures) are essential. “There is a lot of technical progress”, underlines the deputy head of service. These techniques allow “an unprecedented efficacy in very severe depression with 80 to 90% remission in certain clinical forms.”
Different methods are proposed; some of which are relatively light and therefore well accepted by the patient. Repeated transcranial magnetic stimulation is proposed for some depressed patients. “We can choose to stimulate the neurons which are idling. The device is placed on the prefrontal lobe. The sessions are carried out in the hospital, on an outpatient basis.”
Transcranial direct current stimulation is affected for mild or reduced depressions. The protocol is in the process of being validated. “The session is done at home,” says Dr. David Szekely.
Another example of therapeutic evolution: while it was necessary to go through surgery to stimulate the vagus nerve, there are hearing aids that are being studied.
If the health crisis has caused an increase in depressive syndromes and consultations, the evolution of science and techniques offers both more comfort to patients and more hope for a real remission.