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Five years ago, in a wheelchair, Julia Hamm was admitted to a Massachusetts state mental hospital.
After undergoing targeted deep brain stimulation therapy, she hopes to move out soon and live independently in her own apartment for the first time in her adult life.
Hume, 24, has severe obsessive compulsive disorder, or OCD, which has at one point caused her to self-harm and even affect her ability to eat and drink.
“My type of OCD convinced me that food and drinks were contaminated,” Hamm said. Her mind told her such things That the food contains parasites or harmful chemicals.
“I was fully aware of how ridiculous these thoughts were, and I really wanted to gain weight and eat enough and drink enough and be healthy. But my suspicions were very loud,” she said. “They were screaming, and I couldn't focus on anything else.”
Her heart rate and blood pressure became so erratic that she needed to use a wheelchair to get around. Doctors used a tube through her nose to feed her and gave her fluids intravenously.
She is doing much better now after treatment. She received her high school diploma in August and posed for a photo with the certificate, showing a wide smile on her face. She no longer hurts herself, and can eat and drink normally. Intrusive thoughts are no longer in control, she says.
“I feel like my OCD used to be kind to the helmsman, and now it's kind of like a bad passenger. It's there, but it's not taking over my life,” Hume said.
She and her doctors made this life-saving improvement thanks to innovative research that allowed them to precisely target a malfunctioning circuit in her brain with a device called a deep brain stimulator, which acts as a pacemaker.
Deep brain stimulation has been used for two decades for movement disorders such as Parkinson's disease and dystonia. More recently, their use has expanded to include depression and other mood disorders such as Tourette syndrome and OCD.
The devices have two electrodes that target a pea-sized structure deep in the brain called the subthalamic nucleus. This junction, which resembles a contact lens, contains more Half a million neurons.
It is the center where signals pass between the outer and inner layers of the brain. It's like a switchboard, says Dr. Andreas Horn, a neurologist at the Brain Modulation Laboratory at Massachusetts General Hospital.
Doctors implant electrodes near the subthalamic nucleus and then adjust the settings through a pulse generator implanted under the skin of the chest. After waiting for their body to heal for two weeks after the operation, they turn on the electricity and adjust the setting to find something that feels good for the patient.
“Suddenly I feel lighter, less ritualistic, and I sit up straighter and feel more energetic,” Hamm said.
Hamm was implanted with deep brain stimulation in 2021.
Psychiatrist Dr. Darren Dougherty of the Mass General Research Institute did not give them the results they had hoped for at first.
“It was this kind of cycle where we found settings that felt really good. They would probably work for a month or two, and then they would slip back again because the initial results would wear off,” Hamm said.
Deep brain stimulation can be life-changing, but it doesn't work equally for everyone, researchers say, and they're getting closer to understanding why.
as if A recent study Published in the journal Nature Neuroscience, Horn and an international team of researchers took data from more than 530 electrodes implanted in the brains of more than 200 people with: Parkinson's disease, dystonia, Tourette's syndrome and OCD.
They looked at how the devices stimulated each person's brain and how much each of them improved. They then used these records to model the neural networks that appeared to be dysfunctional in each of the four disorders.
“The idea is that by learning from a cohort of patients and comparing those who didn't improve much after treatment, we can identify where the best place is and perhaps the best network to stimulate,” Horne said. .
The team used their maps to adjust deep brain stimulation to three patients, including Hamm.
All showed significant improvement in their symptoms.
Dr. Summer Sheth, professor of neurosurgery at Baylor College of Medicine in Houston, who was not involved in the study, said the study is encouraging because it uses data from many people, but testing only three people is not enough to know if these brain maps are accurate.
“For the most part, this information hasn't been tested in the wild in a new set of patients, so this is what sets it up,” says Sheth, who includes deep brain stimulation.
If the same good results can be replicated in many patients, “then we need to act on it. We need to implant this type of profile in the brain for this type of patient, let's say a patient with OCD,” he said.
Using the maps created by Horne's team and special magnetic resonance imaging, diffusion imaging, doctors can see the fibers they need to stimulate to give people the best chance of healing, Dougherty said.
Each electrode implanted for treatment has multiple contact points that doctors can use to stimulate different parts of the brain.
“We were then able to see which of those contacts were closest to the fiber that might be most useful.” For ham, Dougherty said.
They made adjustments to the Hum settings in August, and she says the difference was night and day.
“It allowed me to focus,” Hume said. She noticed that she was able to participate better in therapy, and was able to create more distance between her thoughts and actions.
“I was able to more accurately label the thought as OCD and I'm not, and I chose to make the decision not to engage in the ritual,” she said.
She can eat and drink “everything.”
“My most basic hope was to have any kind of life, but now it's gotten a lot bigger than that,” says Hamm of her deep brain stimulation.
She wonders if she can go to college, live independently, and have a stable job. And she wonders about love.
“Can I have a strong relationship with my boyfriend and all the things I've missed so far?” She said.
Hume said it's hard to explain how grateful she is to the doctors and researchers who helped her.
“Hope is truly lost. I don't see a future for myself,” she says. “Relight this light and the end of the tunnel.
“He gave me back my hope.”