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See Inside August/September 2006

Turning Off Depression

Helen Mayberg may have found the switch that lifts depression--and shined a light on the real link between thought and emotion

Given her background and curiosity, Helen Mayberg seems to have been destined from girlhood to do what she is doing now--even though her current work was inconceivable then. Her father practiced family medicine in Los Angeles County. Her uncle used x-rays and nuclear medicine machines to research biochemistry. Today Mayberg peers into brains to examine mood networks--and with one startling experiment has transformed the treatment of depression. At the same time, by combining her father's bedside dedication with her uncle's technical sophistication, she is changing the leading theories of how thought and mood interact.

Like many researchers, Mayberg began her career hoping to advance her discipline. She expected to do so in the usual way, by slowly accruing results that would eventually alter the landscape. Now based in Atlanta at Emory University as a professor of psychiatry and neurology, she has indeed achieved such an effect. But last year she also created a big peak all at once, when she and two collaborators described how they cured eight of 12 spectacularly depressed people--individuals virtually catatonic with depression despite years of talk therapy, drugs, even shock therapy. They did so by inserting pacemakerlike electrodes into a spot deep in the cortex known as area 25. A decade earlier Mayberg had identified area 25 as a key conduit of neural traffic between the "thinking" frontal cortex and the central limbic region that gives rise to emotion, which appeared earlier in our evolutionary development. She subsequently found that area 25 runs hot in depressed and sad people--"like a gate left open," as she puts it--allowing negative emotions to overwhelm thinking and mood. Inserting the electrodes closed this gate and rapidly alleviated the depression of two thirds of the trial's patients.

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