Treating depression with electrical stimulation of the spinal cord

Researchers have made a significant breakthrough in the treatment of depression by using a novel method: electrical stimulation of the spinal cord. Their recent pilot clinical trial at the Lindner Center of HOPE, led by Francisco Romo-Nava, MD, PhD, has shown promising results.

Understanding the brain-body connection

Dr. Romo-Nava, an associate professor in the Department of Psychiatry and Behavioral Neurosciences at the University of Cincinnati and a UC Health physician scientist, emphasizes the critical role of brain-body communication in psychiatric disorders.

“We think that the connection between the brain and the body is essential for psychiatric disorders,” said Romo-Nava. “Many of the symptoms of mood disorders or eating disorders or anxiety disorders have to do with what one could interpret as dysregulation in this brain-body interaction.”

Spinal cord/depression connection

The spinal cord, according to Dr. Romo-Nava, plays a key role in conveying information from the body to the brain, impacting our emotional state or mood. In cases of major depressive disorder, this pathway might be overloaded, leading to an ineffective adjustment of mood.

“For example, chronic stress could lead to a hyperactive brain-body circuit that eventually burns the system out and prevents it from adjusting itself in an effective and optimal way,” Romo-Nava said.

To address this, the team developed a noninvasive spinal cord stimulation technique, for which Dr. Romo-Nava obtained a patent in 2020. This method aims to decrease the flow of information in the brain-body circuit, allowing the brain to better regulate itself. “It’s about reducing the noise in the system,” says Romo-Nava.

Methodology and key insights

The trial involved 20 patients, with half receiving active spinal cord stimulation and the other half a control version. Participants underwent three 20-minute sessions weekly for eight weeks.

The primary focus was on the feasibility, safety, and patient tolerance of the stimulation. The device used was compact, with electrodes placed on the patient’s back and shoulder.

Despite being a pilot study with a small sample size, the results were encouraging. Patients receiving active stimulation reported a greater decrease in depressive symptoms. However, Dr. Romo-Nava urges caution in interpreting these results due to the study’s preliminary nature.

“We used a current that is so small that it’s about 10 times smaller than the one known to induce tissue damage, so that’s also pretty encouraging because there’s a lot to explore in terms of what is the optimal dose and session frequency,” he said.

“We need to be cautious when we interpret these results because of the pilot nature and the small sample size of the study,” he said. “While the primary outcome was positive and it shows therapeutic potential, we should acknowledge all the limitations of the study.”

Treating depression through the spinal cord

The treatment showed mild side effects like skin redness and temporary sensations during sessions. Interestingly, the study noted a cumulative decrease in diastolic blood pressure among participants, suggesting a potential impact on autonomic functions.

However, a virtual reconstruction showed that the current from the device moves through the body, reaching the spinal gray matter in the spinal cord, but not the brain itself.

“That supports our hypothesis that it is the modulation of these pathways of information that then may induce an effect on the mood-relevant areas in the brain,” he said. “So it is not the current that reaches the brain, it is the change in the signal that then has an effect. This study is not sufficient to prove all of these components of the hypothesis, but we think it’s a great start.”

Looking ahead, the team is seeking funding for an expanded trial and the development of a portable stimulation device. “Our aim is to confirm the safety and effectiveness of this method for treating psychiatric disorders and to determine the optimal dosage and frequency,” concludes Dr. Romo-Nava.

This research marks a significant step towards understanding and potentially revolutionizing the treatment of depression and other psychiatric disorders.

The full study was published in the journal Molecular Psychiatry.

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