Exploring the ethics of new brain implant technology.
By Dahlia Schilling and Kalyani Puthenpurayil
Recently, the University of California San Francisco conducted a study on whether brain implants can help treat severe and treatment-resistant depression. The experiment has only been conducted on one patient thus far but results look promising and the scientists are looking to continue their work with more patients.
The first trial ran from October 2019 to January 2021 — researchers analyzed data that was collected by the implant, brought in physicians to assess the condition of the patient over time and had the patient log self mood check-ins.
The patient, Sarah, has long struggled with severe depression — none of the medication she took or the treatment she endured has proved beneficial in improving her mental state. No medications were working for her — even going through electroconvulsive therapy, which is currently the most extreme form of treatment for depression, did not end with beneficial results.
Electroconvulsive therapy (ECT) is when electric currents are passed through the brain while the patient is under anesthesia, and can be used to treat severe depression and major bipolar disorders. ECT is a treatment usually done about 12 times per month but results are inconsistent and a major side effect is short seizures, which can be harmful in the long-term. Desperate for any promising treatment, Sarah took it upon herself to participate in the study.
The implant mainly worked in two parts of her brain: the amygdala and the ventral striatum. The amygdala helps define and regulate emotions and works to attach certain feelings and emotions to memories. It also decides how we react to certain emotions and situations. Dr. Katherine Scangos, the lead researcher in the study, said that placing electrodes in the amygdala helped “predict when her symptoms were most severe.”
The ventral striatum is responsible for decision-making and reward-related behavior, hence placing an electrode here stimulated the ventral striatum which largely eliminated feelings of depression.
Two electrodes were linked to the brain implant that was placed in the right hemisphere of her brain — the electrode in the amygdala predicted when symptoms of depression were present, whereas the electrode in the ventral striatum provided stimulation when the other electrode signaled to do so. Because of this, the device is not operating all the time —it only sends six-second electrical bursts when it recognizes depressive-related brain activity.
The surgery to insert the device required drilling small holes into her skull for wires to go through, and frequent checkups are required after the procedure in order to ensure that it has not created any additional problems for the patient. Within a few weeks, Sarah reported that most suicidal thoughts had gone away. A few months later, her depression became significantly more manageable, allowing her to go back to school. While she still experiences slumps and negative thoughts, her depression has grown to become noticeably more manageable due to ECT.
Scientists are attempting to make this treatment more accessible, as this is a very promising study and a revolutionary advancement in the treatment of depression. However, brain implants are expensive and time-consuming to maintain and install. This also raises ethical concerns, with a prominent one being that only those who are able to afford this treatment can receive treatment for their depression.
Junior Anika Agarwal hopes to major in biology, and believes that the brain implant is a revolutionary discovery that can help many individuals who are depressed.
“It’s really cool that [the] device was able to help that person with their symptoms when nothing else would help her,” Agarwal said. “They were [also] able to get the device to predict the depression symptoms. I think that could be really influential in the treatment of depression if it works in clinical trials.”
Senior Aaditya Ravula agrees with Agarwal. He plans to major in Biomedical Engineering and hopes to work on devices like these in the future using advanced technology to solve medical problems and needs.
“The fact that brain implants have been proven to have positive effects on mental health opens up a lot of treatment opportunities for a lot of disorders previously thought untreatable,” Ravula said.
While Ravula knows this is not a treatment option to everyone, he believes it is ethical to help as many people as possible, even if it means only those who can afford this option can get it.
On the other hand, MVHS Biology teacher Pamela Chow is more hesitant about this method/treatment. She also notes that the complexity of the treatment and how one study proving the effectiveness of this technology may not “end up being as easily translatable to the masses.”
“I can see how it’s concerning to people, given the fact that you’re putting electrical pulses in people’s brains,” Chow said. “I also do understand that that’s how the neuron cells are largely communicating, so it makes sense that’s what they’re doing. But in general, I think the idea of electrocuting someone is always a little scary.”
Chow also anticipates that equity and availability issues will surround the brain implant technology.
“The hope would be that in any treatment, you do make sure [that] it’s something people can access regardless of their socioeconomic status,” Chow said. “But it’s also hard because sometimes [researchers] have to try the big stuff, and see what works and then maybe there’s a cheaper version that comes from the big study.”
Meanwhile, Agarwal thinks that such issues are inevitable because society is built in a way where people with more money will always have greater access to services,technologies and treatments compared to those with less money.
Agarwal also believes that this technology shows how people’s perceptions of mental health have changed over time.
“I think devices and discoveries like this show how mental health is being taken more seriously than it was before,” Agarwal said. “People are able to make discoveries and advancements that help people’s mental health when before, it wasn’t really seen as an issue that [is] as prevalent.”