New brain stimulation therapy PACE offers hope for treatment-resistant depression

About one-third of depression patients do not respond to standard antidepressants. A new treatment called PACE uses personalised brain mapping and electrical stimulation to target malfunctioning circuits, offering hope for severe cases, though experts say larger trials are needed.

Hyderabad: It may be quite surprising, but it’s true! About 33 per cent of patients suffering from depression are developing treatment-resistant depression. This means, despite taking treatment in the form of antidepressant medications, such individuals continue to experience symptoms of depression, making them feel as if they are stuck in a deep hole, with no means to climb out.

For such individuals, the world is a place of perpetual shadow, characterised by years of failed treatments, repeated hospitalisations, and a significantly higher risk of suicide.

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Resistant depression is a condition where the brain’s mood-regulating circuits simply do not respond to traditional chemical interventions, leaving patients and their families in a desperate state.

“I urge such patients and their families to have patience and be positive, as psychiatrists worldwide are now able to understand this condition better. There is a lot of hope, as new techniques like Personalised Adaptive Cortical Electro-Simulation (PACE) are showing a lot of promise in treating such patients,” says Dr Vishal Akula, Professor and Head (Psychiatry), Government Medical College in Telangana.

Unlike traditional brain stimulation, which targets the same general area in every patient, PACE uses high-tech functional MRI to create a ‘precision map’ of an individual’s unique brain, allowing clinicians to identify the exact neural circuits that are malfunctioning in a specific person.

By targeting these precise locations with gentle, optimised electrical pulses, doctors can effectively ‘retune’ the brain’s communication networks, offering a potential ladder for those stuck in that previously inescapable hole, says Dr Vishal.

The clinical results of the personalised approach have been remarkable. In one highlighted case, a patient who had lived in the grip of severe depression for over thirty years found that their suicidal thoughts vanished within just seven weeks of starting PACE therapy.

Dr Akula, however, makes it clear that despite the advent of new treatment techniques like PACE, significant challenges persist. “These procedures are highly invasive and require a sophisticated medical infrastructure. Moreover, larger clinical trials are necessary to ensure long-term safety across the population,” he says.

The senior psychiatrist pointed out that patients and their families must realise that mental illnesses are deeply rooted in brain biology. As technology improves, there is every chance of reclaiming life from despair,” Dr Vishal said.

33 per cent of patients with depression develop resistant-depression

Such patients continue to suffer, despite taking medicines

New treatment modalities like Personalised Adaptive Cortical Electro-Simulation (PACE) show a lot of promise

PACE, with the help of MRI scans, creates a ‘precision map’ of brain

Such maps allow physicians to identify parts of the brain that are malfunctioning

Such areas can be targeted with a gentle light pulse to retune the brain

New technology yet to undergo massive clinical trials