Helen S. Mayberg

Last updated
Helen S. Mayberg, M.D.
Born
California
NationalityAmerican
Citizenship United States
Education
Medical career
ProfessionResearcher, Professor, Medical Doctor
FieldPsychiatry, Behavioral sciences, Neurology, Radiology

Helen S. Mayberg (born 1956 in California), is an American neurologist. Mayberg is known in particular for her work delineating abnormal brain function in patients with major depression using functional neuroimaging. [1] [2] This work led to the first pilot study of deep brain stimulation (DBS), a reversible method of selective modulation of a specific brain circuit, for patients with treatment-resistant depression. As of August 2019, she has published 211 original peer-reviewed articles, 31 books and book chapters, and acted as principal investigator on 24 research grants. Mayberg is coinventor with Andres Lozano of “Method for Treating Depression Mood Disorders and Anxiety Disorders using Neuromodulation,” US patent 2005/0033379A1. St. Jude Medical Neuromodulation licensed her intellectual property to develop Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Unipolar and Bipolar Depression (SCC DBS) for the treatment of severe depression. [3] [4] [5] As of 2018, Mayberg holds positions as Professor of Neurology and Neurosurgery and Professor, Psychiatry and Neuroscience, both at Mount Sinai Medical School, and Professor of Psychiatry, Emory University; Emory University Hospital. [6] Since 2018, she has served as Director, Nash Family Center for Advanced Circuit Therapeutics at the Icahn School of Medicine at Mount Sinai. [7] [8] [9] [10] [11] [12]

Contents

Research

Mayberg's research in neurology came about through observations that the psychological diagnoses of mental disorders was not aided by, or backed up by, neurological evidence—and that developing a system of mapping the circuitry of brain activity would allow for more objective diagnoses and treatment. [13] [14] [15]

Mayberg studies depression and integrates neuroimaging strategies such as Positron emission tomography (PET), [16] sMRI, fMRI, DTI, and EEG as well as behavioral and psychophysiological metrics to define brain mechanisms and testing of antidepressant treatments. She develops imaging biomarkers [17] and algorithms that discriminate patient subgroups and optimize treatment selection in the management of individual patients across all stages of illness. She also concentrates on testing deep brain stimulation for treatment resistant depression, bringing together electro physiologists, engineers, imaging scientists and clinicians to refine, optimize and extend the treatment of depression and other neuropsychiatric disorders. [18]

Since the 1990s, electric stimulation of parts of the brain have been used to treat Parkinsons. The origins of DBS date back to the 1930s. [19] [20]

One deep brain stimulation treatment for depression, developed by Mayberg and colleagues, placed electrodes in the Broadmann area 25 of the brain in severely depressed patients. Initial results were encouraging, though clinical trials were deemed futile and ultimately halted; however, there were positive changes in the success rate of the trial after the trial was halted. As a result, she resumed research on her hypothesis. [7] Area 25 is connected to parts of the brain that are related to observable depression traits, such as appetite and sleeping habits. Her hypothesis is sometimes described as a pacemaker for the brain: electronic pulses that correct both the cause and the symptoms of depression. [21] Current research looks into why some patients respond to DBS and others do not. [22] To this end, a study led by Dr. Mayberg showed that brief intraoperative exposure to therapeutic stimulation at the time of implantation surgery induces rapid and consistent electrophysiological brain state change—indexed by a decrease in Beta wave measured at the site of stimulation. These intraoperative brain state changes are seen in individual subjects and are correlated with a significant and sustained reduction in depressive symptoms outside of the operating room without additional stimulation, establishing reduction in beta power as a novel biomarker for DBS treatment optimization. [23]

Grants

A partial list of recent grants:

Grants, Contracts and Foundation Sources
Title and No.RoleDirect Costs (USD)
Emory-MSSM-GSK-NIMH Collaborative Mood-Anxiety Disorders Initiative, NIMH - U19 MH069056-09Principal Investigator$11,133,630
Psychophysiological Assessment of DBS Effects in TRD Phase  II, Hope for Depression Research FoundationPrincipal Investigator$550,000
Predictors of Antidepressant Treatment Response: The Emory CIDAR, NIMH  - P50 MH077083-01Principal Investigator$7,500,000
Multimodal Assessment of DBS Effects in TRD Phase I, Hope for Depression Research FoundationPrincipal Investigator$400,000

Meditation and depression

In 2017, Mayberg and the 14th Dalai Lama of Tibet attended a conference on mindfulness and the impact of meditation on the brain. The Dalai Lama was interested in whether the brain impacts the mind or if it might be the other way around. Mayberg pointed out the impact of DBS on severely depressed individuals. Their informal hypothesis was that, based on experiments that examined brain behavior from people practicing meditation, and experiments involving DBS, it was likely that meditation could improve brain waves that are important to mental health — yet when a patient experiences a certain degree of depression, it takes biological treatment to restore the patient to where they can meditate at all. [24] [25] [26]

Neuroethics

One issue surrounding DBS is that it stands to change a patient’s identity or cause other undesirable emotional or biological conditions. The rebuttal is that severely depressed individuals often have lost a sense of self and that invasive procedures can block the barrier that might be the root cause of the loss of self, thereby restoring it. [27]

Mayberg gave a presentation in 2014 at the Presidential Commission for the Study of Bioethical Issues, where she expressed her clinical and experiential lessons in neuroethics. Her commentary focused on how severely depressed patients are rarely irrational, and that there needs to be open communication and a two-way understanding of expectations. She also asserted in publications that DBS patients should have their own words reflected in the medical literature. [28] [29]

Neurolaw

Neurolaw, related to Neurocriminology, is based on the concept that MRI and PET scans as well as other means of examining of a person’s brain composition, can be used to hold harmless an alleged perpetrator in a court of law. Or, conversely, to justify a conviction. Adrian Raine was among those who postulated this theory in the 1980s, and it gained attention in the press after the trial and conviction of John Hinckley Jr. [30] [31]

Other scholars, including Mayberg, have argued in editorials and interviews that science of the brain cannot be used, at least at this point, to offer evidence for a conviction. By extension, it could be erroneously interpreted that brain analyses could predict a person’s potential for criminal behavior. [32] [33] [34]

Membership and awards

Memberships and associations

Mayberg is a member of the Governing Board of the International Neuroethics Society, the Institute of Medicine, the Dana Alliance and the NARSAD Scientific Advisory Board. She is active in the Society for Neuroscience, Society of Biological Psychiatry, American Neurological Association, American College of Neuropsychopharmacology, the Organization for Human Brain Mapping, and serves on the editorial boards of Human Brain Mapping (associate editor), NeuroImage, Clinical, Biological Psychiatry (ex officio editor), Brain Stimulation, Neuroinformatics, Neuromodulation (associate editor) and Brain Structure and Function. [28] [35]

Honors and awards

A list of honors and awards include election to Johns Hopkins University Society of Scholars (2018), recipient, Steven E. Hyman Award for Distinguished Service to the Field of Neuroethics (2018), elected to the National Academy of Medicine (2008); American Academy of Arts and Sciences (2017) and National Academy of Inventors, elected member (2016), V. Sagar Sethi Mental Health Research Award, Psychiatric Foundation of North Carolina (2016), the Gold Medal Award, Society of Biological Psychiatry (2014), Joan and Stanford Alexander Award in Psychiatry (2013), the Robert J. and Claire Pasarow Foundation Medical Research Award (2013), and others. [36] [37] [38] [39] [40] [41] [42] [10] [11] [12]

Publications

Partial list of original peer-reviewed articles ranked by citations:

Related Research Articles

<span class="mw-page-title-main">Transcranial magnetic stimulation</span> Brain stimulation using magnetic fields

Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation in which a changing magnetic field is used to induce an electric current at a specific area of the brain through electromagnetic induction. An electric pulse generator, or stimulator, is connected to a magnetic coil connected to the scalp. The stimulator generates a changing electric current within the coil which creates a varying magnetic field, inducing a current within a region in the brain itself.

<span class="mw-page-title-main">Deep brain stimulation</span> Neurosurgical treatment involving implantation of a brain pacemaker

Deep brain stimulation (DBS) is a surgical procedure that implants a neurostimulator and electrodes which sends electrical impulses to specified targets in the brain responsible for movement control. The treatment is designed for a range of movement disorders such as Parkinson's disease, essential tremor, and dystonia, as well as for certain neuropsychiatric conditions like obsessive-compulsive disorder (OCD) and epilepsy. The exact mechanisms of DBS are complex and not entirely clear, but it is known to modify brain activity in a structured way.

Neurotechnology encompasses any method or electronic device which interfaces with the nervous system to monitor or modulate neural activity.

<span class="mw-page-title-main">Vagus nerve stimulation</span> Medical treatment that involves delivering electrical impulses to the vagus nerve.

Vagus nerve stimulation (VNS) is a medical treatment that involves delivering electrical impulses to the vagus nerve. It is used as an add-on treatment for certain types of intractable epilepsy, cluster headaches, treatment-resistant depression and stroke rehabilitation.

Neurohacking is a subclass of biohacking, focused specifically on the brain. Neurohackers seek to better themselves or others by “hacking the brain” to improve reflexes, learn faster, or treat psychological disorders. The modern neurohacking movement has been around since the 1980s. However, herbal supplements have been used to increase brain function for hundreds of years. After a brief period marked by a lack of research in the area, neurohacking started regaining interest in the early 2000s. Currently, most neurohacking is performed via do-it-yourself (DIY) methods by in-home users.

<span class="mw-page-title-main">Brodmann area 25</span> Part of the brain

Brodmann area 25 (BA25) is the subgenual area, area subgenualis or subgenual cingulate area in the cerebral cortex of the brain and delineated based on its cytoarchitectonic characteristics.

Treatment-resistant depression is a term used in psychiatry to describe people with major depressive disorder (MDD) who do not respond adequately to a course of appropriate antidepressant medication within a certain time. Definitions of treatment-resistant depression vary, and they do not include a resistance to psychological therapies. Inadequate response has most commonly been defined as less than 50% reduction in depressive symptoms following treatment with at least one antidepressant medication, although definitions vary widely. Some other factors that may contribute to inadequate treatment are: a history of repeated or severe adverse childhood experiences, early discontinuation of treatment, insufficient dosage of medication, patient noncompliance, misdiagnosis, cognitive impairment, low income and other socio-economic variables, and concurrent medical conditions, including comorbid psychiatric disorders. Cases of treatment-resistant depression may also be referred to by which medications people with treatment-resistant depression are resistant to. In treatment-resistant depression adding further treatments such as psychotherapy, lithium, or aripiprazole is weakly supported as of 2019.

<span class="mw-page-title-main">Medial forebrain bundle</span>

The medial forebrain bundle (MFB) is a neural pathway containing fibers from the basal olfactory regions, the periamygdaloid region and the septal nuclei, as well as fibers from brainstem regions, including the ventral tegmental area and nigrostriatal pathway.

Cordance, a measure of brain activity, is a quantitative electroencephalographic (QEEG) method, developed in Los Angeles in the 1990s. It combines complementary information from absolute and relative power of EEG spectra.

<span class="mw-page-title-main">Responsive neurostimulation device</span> Category of medical devices that respond to signals in a patients body to treat disease

Responsive neurostimulation device is a medical device that senses changes in a person's body and uses neurostimulation to respond in the treatment of disease. The FDA has approved devices for use in the United States in the treatment of epileptic seizures and chronic pain conditions. Devices are being studied for use in the treatment of essential tremor, Parkinson's disease, Tourette's syndrome, depression, obesity, and post-traumatic stress disorder.

Ablative brain surgery is the surgical ablation by various methods of brain tissue to treat neurological or psychological disorders. The word "Ablation" stems from the Latin word Ablatus meaning "carried away". In most cases, however, ablative brain surgery does not involve removing brain tissue, but rather destroying tissue and leaving it in place. The lesions it causes are irreversible. There are some target nuclei for ablative surgery and deep brain stimulation. Those nuclei are the motor thalamus, the globus pallidus, and the subthalamic nucleus.

Management of depression is the treatment of depression that may involve a number of different therapies: medications, behavior therapy, psychotherapy, and medical devices.

Neuromodulation is "the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body". It is carried out to normalize – or modulate – nervous tissue function. Neuromodulation is an evolving therapy that can involve a range of electromagnetic stimuli such as a magnetic field (rTMS), an electric current, or a drug instilled directly in the subdural space. Emerging applications involve targeted introduction of genes or gene regulators and light (optogenetics), and by 2014, these had been at minimum demonstrated in mammalian models, or first-in-human data had been acquired. The most clinical experience has been with electrical stimulation.

<span class="mw-page-title-main">Krembil Research Institute</span> Academic medical research institute in Toronto

The Krembil Research Institute, formerly known as the Toronto Western Research Institute, is an academic medical research institute in Toronto. It is one of the largest research institutes in Canada focusing on human neurological disease.

Charles L. Raison is an American psychiatrist and professor of psychiatry at the University of Wisconsin-Madison School of Medicine and Public Health as well as the Mary Sue and Mike Shannon Chair for Healthy Minds, Children & Families and Professor with the School of Human Ecology in Madison, Wisconsin.

<span class="mw-page-title-main">Abraham Zangen</span> Israeli researcher

Abraham Zangen is an Israeli professor of neuroscience, head of the brain stimulation and behavior lab and chair of the psychobiology brain program at Ben-Gurion University of the Negev (BGU).

Ali R. Rezai is an Iranian-born American neurosurgeon and neuroscientist. His work and research has focused on neuromodulation treatments for patients with neurological and mental health conditions, including neuromodulation techniques such as deep brain stimulation (DBS) through brain chip implants to treat Parkinson's disease tremors, obsessive–compulsive disorder, Alzheimer's disease, traumatic brain injury, spinal cord injury, and addiction. Recent research since 2020 has focused on deep brain stimulation for addiction treatment, as well as focused ultrasound to treat tremor, addiction and Alzheimer's disease.

<span class="mw-page-title-main">Meaghan Creed</span> Canadian Neuroscientist

Meaghan Creed is a Canadian neuroscientist and associate professor of anesthesiology at Washington University in St. Louis. Creed has conducted research on understanding and optimizing deep brain stimulation in the basal ganglia for the treatment of neurological and psychiatric disorders. Her work has been recognized at the national and international level by Pfizer, the American Association for the Advancement of Science (AAAS), the Whitehall Foundation, Brain and Behavior Research Foundation and the Rita Allen Foundation.

<span class="mw-page-title-main">Alberto Priori</span> Italian neurologist

Alberto Priori is an Italian neurologist, academic, and author. He is a Professor of Neurology at the University of Milan, Director of Neurology 1 Unit at San Paolo Hospital, and the Founder and Coordinator of Aldo Ravelli Center of the University of Milan. He also serves as President of the Neurophysiopatology Techniques Course, and Professor of Postgraduate Schools - Medicine, Healthcare, Dental Medicine at the same University.

<span class="mw-page-title-main">Adaptive Deep Brain Stimulation</span> Neurosurgical treatment involving implantation of an adaptive neurostimularot

Adaptive Deep Brain Stimulation (aDBS), also known as Closed Loop Deep Brain stimulation (clDBS), is a neuro-modulatory technique currently under investigation for the treatment of neurodegenerative diseases.

References

  1. ↑ "Witness: Ex-soldier suffered from impulse control issues". NBC News . Paducah, Kentucky. 2009-05-12. Retrieved 2018-02-12. Ruben Gur, director of neuropsychology at the University of Pennsylvania School of Medicine, told jurors Tuesday that former Pfc. Steven Dale Green would be prone to acting inappropriately in chaotic situations because of the brain damage. Gur, testifying for the defense, said the brain damage likely was caused by several head injuries.
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  27. ↑ "When It Comes to Issues of Identity and Authenticity in DBS, Let Patients Have a Voice". www.sfn.org. Retrieved 2019-12-11.
  28. 1 2 "Leadership". www.neuroethicssociety.org. Retrieved 13 February 2018.
  29. ↑ "Transcript, Meeting 18, Session 3 | Presidential Commission for the Study of Bioethical Issues". bioethicsarchive.georgetown.edu. Retrieved 2019-12-11.
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