posted 07-01-99 03:21 AM ET        

Taken from today's Financial Times

Shedding light on the mind's darker side

Research supports the argument that depression should be taken seriously as a medical condition, writes Michael Peel

The patient began to look sad less than five seconds after the electric current had been applied to her brain. Soon she started to cry and expressed feelings of sadness, guilt, uselessness and hopelessness.

When asked why she was crying and if she felt pain, she responded: "No, I'm fed up with life, I've had enough . . . I don't want to live any more, I'm disgusted with life . . . Everything is useless, always feeling worthless, I'm scared in this world."

The depression ceased less than 90 seconds after the current had been switched off. The patient was in a slightly manic state for the next five minutes, laughing and playing with her examiner's tie before her behaviour returned to normal.

This episode, reported in the New England Journal of Medicine, provides a remarkable insight into the nature of depression. It offers much sought-after evidence that the condition might be "hard-wired" into the brain, supporting experts who have campaigned for years against those who view the illness as a manifestation of self-indulgence and weakness.

The work, says the Journal, raises fundamental and far-reaching questions about medical approaches to the condition. It asks whether electric current might be used in other areas of the brain to treat conditions such as alcoholism, substance abuse and aggression.

The research provides a new twist to efforts to alter the workings of the brain using electric current. It is many decades since the neurosurgeon Dr Wilder Penfield reported the activation of so-called "psychical" states by stimulation of the brain with an electrical probe. A technique known as electroconvulsive therapy (ECT) is sometimes used to combat severe depression, although scientists are unsure how it works.

It remains, according to one psychiatrist, an unsatisfactory "blunt instrument" at best.

The latest research has attracted attention because the effect was traced to a specific part of the brain, called the substantia nigra.

The team, from the neurology department of the H�pital de la Salp�tri�re in Paris, was studying the effects of electrical stimulation on Parkinson's Disease, a cerebral condition that causes rigidity and then tremors in the muscles.

While working on one of 20 subjects, the group stumbled on the startling effect described above. The subject, a 65-year-old woman, had no known history of depression, suggesting it was unlikely that the current was triggering memories of depressive episodes.

It was, said the team, an example of "major reversible depression". The patient, who recalled the entire episode, behaved as if the condition had been switched on and then off, leaving no residual effects.

This concept of the brain as a kind of advanced circuit complements work in progress at the Institute of Psychiatry at London's Maudsley Hospital. Researchers are trying to discover whether there are neurological differences between sufferers and non-sufferers of depression.

The team is conducting work on a condition known as anhedonia, which renders sufferers unable to derive enjoyment from normally pleasurable experiences. They are using brain imaging to study the difference between the emotional responses of sufferers and non-sufferers shown clips from films such as When Harry Met Sally.

The team hopes the work may help them distinguish sufferers of clinical depression from people who are merely feeling a little unhappy. "What people need to do now is say: 'How can we work out the neural circuitry that modulates depression?'" says Tonmoy Sharma, head of cognitive psychopharmacology at the institute. "Once we work that out we will be able to develop drugs that are much more specific."

The French research falls short of providing conclusive proof that the brain operates in this way. Many people who work with sufferers of depression point out that the phenomenon was apparently observed in only one of the 20 patients and that the effect was only short-lived.

One psychiatrist adds that there is a difference between treating depression, which can be influenced by drug-or electrically-induced changes in brain chemistry, and the other conditions listed by the Journal as possible subjects of future investigation. "None of them has been demonstrated to have a biochemical abnormality associated with them," says Ruth Hirons, psychiatrist and senior psychotherapist with the British Association of Psychotherapists.

Others point out that the function of the substantia nigra might have been changed by the onset of Parkinson's Disease. "It's an area that has been identified as diseased in Parkinson's Disease," says one psychotherapist. "So I think one has to say that they are interesting observations but we don't know how generalisable they are."

However, he adds it is fascinating to know that it is possible to alter mood states by stimulating the substantia nigra. The region is deep in the brain and is rarely investigated, as it controls motor functions rather than higher critical faculties.

For the Journal, the result of the work into this relatively unresearched part of the brain suggests depression could have an evolutionary aspect. It might intensify the grief reaction to death, enhancing the kind of conjugal and parental bonding that causes adults to protect partners and vulnerable offspring from predators.

Much more research will be needed to prove such a far-reaching hypothesis. We are a long way, too, from the world conjured up by the Journal, in which a range of feelings and perceptions are controlled with electrical devices that stimulate the cells of our brains.

posted 07-01-99 10:19 AM ET            

So you don't think hooking electrical devices up to your brain against your will is a form of violence? Excellent... I'll be by with my jumper cables in a few minutes...

Seriously, though, why is it surprising to anyone that applying electrical impulses to the brain can create substantial behavioral effects? That's what the brain does.

posted 07-01-99 01:36 PM ET            

I seem to remember it was made into a film, even though the original was only a short story, IIRC. Anyone remember the cast list?

Not sleeping too well at the moment, so I sometimes watch some of the Learning Zone stuff on late night BBC, and last night it was about the physical structure of the brain. Quite a coincidence. Also caught the beginning of a discussion about intelligence on Radio 4, but only the first few minutes, because I should have been at work at the time! Seems that there is a lot going on at the moment in the whole general area of the brain, intelligence and consciousness. My current interest is mainly in evolution, but I'll probably be reading some books about language in the near future (Pinker et al) and that will probably take me on to the brain and its workings. Any recommendations for a reading list? Not too heavy to start off with, please.