Deep brain stimulation, or DBS, is an experimental treatment that involves having an electrical device placed in the brain.
深部脑刺激，简称DBS，是一种实验性治疗方法，将一个电子设备放置在大脑中。
The treatment gives patients' brains targeted electrical impulses.
这种疗法给病人的大脑提供有针对性的电脉冲。
Researchers say DBS could help some of the nearly 3 million Americans with depression that resists other treatments. It is approved for conditions like Parkinson's disease and epilepsy. Many doctors and patients hope it will become more widely available for depression.
研究人员表示，DBS可以帮助近300万美国抑郁症患者中的一些人，这些人对其他治疗方法都有抵抗力。它被批准用于治疗帕金森病和癫痫等疾病。许多医生和病人希望它能更广泛地用于治疗抑郁症。
Recent research suggests gains are possible and more research is planned. However, two earlier studies showed no gains using DBS for depression. Those results have slowed the treatment that involves a brain operation. Some scientists continue to raise concerns about DBS.
最近的研究表明，有可能取得进展，并计划进行更多的研究。然而，早前的两项研究显示，使用DBS治疗抑郁症没有任何效果。这些结果延缓了涉及脑部手术的治疗。一些科学家继续提出对DBS的担忧。
The U.S. Food and Drug Administration (FDA) has agreed to speed up its study of Abbott Laboratories' request to use its DBS devices for treatment-resistant depression.
美国食品和药物管理局(FDA)已同意加快对雅培公司使用DBS设备治疗难治性抑郁症的请求的研究。
"Nothing else was working"
“别的都不行”
Emily Hollenbeck lived with severe depression. She compared it to a black hole. She felt as though her arms and legs could barely move. She knew both of her parents had taken their lives and that her condition was dangerous.
艾米丽·霍伦贝克患有严重的抑郁症。她把它比作黑洞。她觉得自己的胳膊和腿几乎不能动了。她知道她的父母都自杀了，她的情况很危险。
Hollenbeck, who grew up poor and sometimes homeless, suffered from signs of depression as a child. In college, after her father's suicide in 2009, she had her first period of major depression. Another happened while she was working. She was concerned she would lose her teaching job and become poor again. She went to the hospital.
霍伦贝克在贫困中长大，有时无家可归，小时候患有抑郁症的迹象。2009年父亲自杀后，她上了大学，第一次患上了重度抑郁症。另一起发生在她工作的时候。她担心自己会失去教书的工作，再次变穷。她去了医院。
"I ended up having sort of an on-and-off pattern," she said. Medication helped her for a while.
“我最终形成了一种时断时续的模式，”她说。药物治疗帮助了她一段时间。
She was able to earn a doctoral degree in psychology although she lost her mom in her final year of graduate school. But the depression stayed with her. At times, she said, she thought about ending her life.
她能够获得心理学博士学位，尽管她在研究生院的最后一年失去了母亲。但抑郁症一直困扰着她。她说，有时她想结束自己的生命。
She was willing to try something extreme.
她愿意尝试一些极端的东西。
Her doctor then told her about DBS three years ago.
三年前，她的医生告诉她脑起搏术。
"Nothing else was working," she said.
“其他方法都不起作用，”她说。
She became one of a few hundred people to have her depression treated with DBS.
她成为数百名接受DBS治疗的抑郁症患者之一。
Hollenbeck is part of ongoing research at Mount Sinai West medical center in New York City. Her brain operation took place while she was sedated but still awake. Dr. Brian Kopell directs Mount Sinai's Center for Neuromodulation. He placed thin metal electrodes in the part of her brain believed to control emotional behavior and is thought to be involved in feelings of sadness.
Hollenbeck是纽约市西奈山医疗中心正在进行的研究的一部分。她的脑部手术是在她服用镇静剂但仍然清醒的情况下进行的。布莱恩·科佩尔博士是西奈山神经调节中心的主任。他在她大脑中被认为控制情绪行为的部分放置了薄金属电极，该部分被认为与悲伤的感觉有关。
The thin metal electrodes are connected by wires to a device placed under the skin of her chest. The device controls the electrical impulses sending current to her brain.
薄薄的金属电极通过电线连接到放置在她胸部皮肤下的装置上。这个装置控制着向她的大脑发送电流的电脉冲。
Doctors involved in DBS say the impulses help because the brain uses electricity to send signals.
参与DBS的医生表示，这种脉冲有帮助，因为大脑使用电来发送信号。
In normal brains, Kopell said, electrical activity spreads through the brain unblocked to all areas. In depression, he said, the brain's emotional signals get blocked. He compared the problem to dancing. He said DBS seems to "unstick the circuit," permitting the brain to do what it normally would. A circuit is the path unblocked electrical current takes.
科佩尔说，在正常的大脑中，电活动通过大脑畅通无阻地传播到所有区域。他说，在抑郁症中，大脑的情绪信号被阻断了。他把这个问题比作跳舞。他说，DBS似乎“解开了回路”，允许大脑做它通常会做的事情。电路是电流畅通的路径。
Hollenbeck said the effect on her was almost immediate.
霍伦贝克说，这对她的影响几乎是立竿见影的。
"The first day after surgery, she started feeling a lifting of that negative mood, of the heaviness," said her psychiatrist, Dr. Martijn Figee.
“手术后的第一天，她就开始感觉到负面情绪和沉重感有所缓解，”她的精神科医生马丁·菲吉说。
For Hollenbeck, the biggest change was finding pleasure in music again.
对霍伦贝克来说，最大的变化是再次在音乐中找到乐趣。
She wishes her treatment had been available for her parents.
她希望她的父母也能接受这种治疗。
The treatment's history
治疗的历史
DBS research has continued for at least 20 years. Brain expert Dr. Helen Mayberg led early research that was called promising. But large studies launched more than 12 years ago saw no difference in treated and untreated groups.
星展银行的研究已经持续了至少20年。大脑专家海伦·梅伯格博士领导的早期研究被称为有希望的。但12年前开展的大型研究发现，治疗组和未治疗组之间没有差异。
Dr. Katherine Scangos is a psychiatrist at the University of California, San Francisco. She is also researching DBS and depression. She said there could be two reasons for the major studies showing no effect.
凯瑟琳·斯坎戈斯博士是加州大学旧金山分校的精神病学家。她也在研究脑起搏器和抑郁症。她说，主要研究显示没有效果可能有两个原因。
She said one reason was that the treatment was not "personalized" for each individual in the two studies. The second was that researchers looked at outcomes over just a few weeks.
她说，其中一个原因是，在这两项研究中，治疗并不是针对每个人的“个性化”。第二，研究人员只观察了几周的结果。
Recent research has shown more promising results for depression. A 2022 study said that on average 60 percent of depression patients showed improvement with DBS. A study from 2023 said that after six months of targeted DBS treatment, 90 percent of subjects showed improvements. Seventy percent were no longer considered medically depressed.
最近的研究显示了治疗抑郁症的更有希望的结果。2022年的一项研究表明，平均60%的抑郁症患者在接受DBS治疗后有所改善。2023年的一项研究表明，经过六个月的定向DBS治疗，90%的受试者表现出改善。70%的人不再被认为患有医学上的抑郁症。
Treatments being tested by teams today target individual patients more closely. The team at Mount Sinai, for example, is using brain imaging to find the right place to put electrodes in the brain.
如今，团队正在测试的治疗方法更密切地针对个体患者。例如，西奈山的研究小组正在利用脑成像技术寻找在大脑中放置电极的合适位置。
Mayberg is also with Mount Sinai. She said, "Everybody's brain is a little different, just like people's eyes are a little further apart or a nose is a little bigger or smaller."
Mayberg也在西奈山工作。她说:“每个人的大脑都有一点不同，就像人们的眼睛稍微分开一点，鼻子稍微大一点或小一点。”
Looking ahead
展望未来
Medical devices manufacturer Abbott Laboratories is launching a large clinical trial on patients this year, ahead of a possible decision by the FDA.
医疗设备制造商雅培实验室今年将在FDA可能做出决定之前，对患者进行一项大型临床试验。
Scangos said: "I'm hoping we will have approval within a short time."
Scangos表示:“我希望我们能在短时间内获得批准。”
But some doctors have concerns. They point to possible dangers of having a brain operation, which include bleeding, stroke and infection.
但一些医生对此表示担忧。他们指出了脑部手术可能存在的危险，包括出血、中风和感染。
Dr. Stanley Caroff is a professor of psychiatry at the University of Pennsylvania. He said scientists do not know the exact pathways or systems in the brain that produce depression. That makes it difficult to send the impulses to the right place.
斯坦利·卡洛夫博士是宾夕法尼亚大学的精神病学教授。他说，科学家们并不知道大脑中产生抑郁症的确切途径或系统。这使得很难将冲动发送到正确的地方。
"I believe from a psychiatric point of view, the science is not there," he said of DBS for depression.
“我相信，从精神病学的角度来看，科学并不存在，”他谈到DBS治疗抑郁症时说。
Moving forward
前进
Hollenbeck said DBS has not cured her. She still takes medicines for depression and needs ongoing care.
Hollenbeck说DBS并没有治愈她。她仍在服用治疗抑郁症的药物，需要持续的护理。
She recently visited Mayberg of Mount Sinai in her office and discussed recovery. "It's not about being happy all the time," Mayberg told her. "It's about making progress."
她最近去西奈山的梅伯格的办公室拜访了她，讨论了康复问题。“这并不是说要一直快乐，”梅伯格告诉她。“这是关于进步的。”
Researchers are studying the progress patients make. Recent research by Mayberg and others published in Nature said scientists can study brain activity to see how someone is doing at any given time.
研究人员正在研究患者的病情进展。梅伯格等人最近在《自然》杂志上发表的研究称，科学家可以通过研究大脑活动来了解一个人在任何特定时间的行为。
Study subjects can provide data from their homes about how they feel. Subjects answer questions and send data from their devices to researchers. They also send videos where researchers can observe speech and facial movements.
研究对象可以在家中提供有关自己感受的数据。受试者回答问题并将数据从他们的设备发送给研究人员。他们还发送视频，研究人员可以观察语音和面部动作。
Additionally, patients go to Mount Sinai so researchers can collect more information about their body movements. Hollenbeck, for example, is showing faster movements as her condition improves.
此外，病人去西奈山，这样研究人员就可以收集更多关于他们身体运动的信息。例如，随着病情的好转，霍伦贝克的运动速度加快了。
The data gained, combined with other information like life events, records how she is doing. This helps guide doctors' decisions about treatment, like increasing the amount of electricity used — which they did once.
所获得的数据，结合生活事件等其他信息，记录了她的行为。这有助于指导医生关于治疗的决定，比如增加用电量——他们曾经这样做过。
Hollenbeck showed AP the scars on her chest and head where doctors had placed the DBS devices. To her, they were signs of how far she had come.
Hollenbeck向美联社展示了她胸部和头部的伤疤，医生在那里放置了DBS装置。对她来说，这些标志着她已经走了多远。
She added, "...I'm able to see and remember, even on a bodily level, that I'm going to be OK."
她补充说:“……我能够看到并记住，甚至在身体层面上，我会没事的。”
深部脑刺激，简称DBS，是一种实验性治疗方法，将一个电子设备放置在大脑中。
The treatment gives patients' brains targeted electrical impulses.
这种疗法给病人的大脑提供有针对性的电脉冲。
Researchers say DBS could help some of the nearly 3 million Americans with depression that resists other treatments. It is approved for conditions like Parkinson's disease and epilepsy. Many doctors and patients hope it will become more widely available for depression.
研究人员表示，DBS可以帮助近300万美国抑郁症患者中的一些人，这些人对其他治疗方法都有抵抗力。它被批准用于治疗帕金森病和癫痫等疾病。许多医生和病人希望它能更广泛地用于治疗抑郁症。
Recent research suggests gains are possible and more research is planned. However, two earlier studies showed no gains using DBS for depression. Those results have slowed the treatment that involves a brain operation. Some scientists continue to raise concerns about DBS.
最近的研究表明，有可能取得进展，并计划进行更多的研究。然而，早前的两项研究显示，使用DBS治疗抑郁症没有任何效果。这些结果延缓了涉及脑部手术的治疗。一些科学家继续提出对DBS的担忧。
The U.S. Food and Drug Administration (FDA) has agreed to speed up its study of Abbott Laboratories' request to use its DBS devices for treatment-resistant depression.
美国食品和药物管理局(FDA)已同意加快对雅培公司使用DBS设备治疗难治性抑郁症的请求的研究。
"Nothing else was working"
“别的都不行”
Emily Hollenbeck lived with severe depression. She compared it to a black hole. She felt as though her arms and legs could barely move. She knew both of her parents had taken their lives and that her condition was dangerous.
艾米丽·霍伦贝克患有严重的抑郁症。她把它比作黑洞。她觉得自己的胳膊和腿几乎不能动了。她知道她的父母都自杀了，她的情况很危险。
Hollenbeck, who grew up poor and sometimes homeless, suffered from signs of depression as a child. In college, after her father's suicide in 2009, she had her first period of major depression. Another happened while she was working. She was concerned she would lose her teaching job and become poor again. She went to the hospital.
霍伦贝克在贫困中长大，有时无家可归，小时候患有抑郁症的迹象。2009年父亲自杀后，她上了大学，第一次患上了重度抑郁症。另一起发生在她工作的时候。她担心自己会失去教书的工作，再次变穷。她去了医院。
"I ended up having sort of an on-and-off pattern," she said. Medication helped her for a while.
“我最终形成了一种时断时续的模式，”她说。药物治疗帮助了她一段时间。
She was able to earn a doctoral degree in psychology although she lost her mom in her final year of graduate school. But the depression stayed with her. At times, she said, she thought about ending her life.
她能够获得心理学博士学位，尽管她在研究生院的最后一年失去了母亲。但抑郁症一直困扰着她。她说，有时她想结束自己的生命。
She was willing to try something extreme.
她愿意尝试一些极端的东西。
Her doctor then told her about DBS three years ago.
三年前，她的医生告诉她脑起搏术。
"Nothing else was working," she said.
“其他方法都不起作用，”她说。
She became one of a few hundred people to have her depression treated with DBS.
她成为数百名接受DBS治疗的抑郁症患者之一。
Hollenbeck is part of ongoing research at Mount Sinai West medical center in New York City. Her brain operation took place while she was sedated but still awake. Dr. Brian Kopell directs Mount Sinai's Center for Neuromodulation. He placed thin metal electrodes in the part of her brain believed to control emotional behavior and is thought to be involved in feelings of sadness.
Hollenbeck是纽约市西奈山医疗中心正在进行的研究的一部分。她的脑部手术是在她服用镇静剂但仍然清醒的情况下进行的。布莱恩·科佩尔博士是西奈山神经调节中心的主任。他在她大脑中被认为控制情绪行为的部分放置了薄金属电极，该部分被认为与悲伤的感觉有关。
The thin metal electrodes are connected by wires to a device placed under the skin of her chest. The device controls the electrical impulses sending current to her brain.
薄薄的金属电极通过电线连接到放置在她胸部皮肤下的装置上。这个装置控制着向她的大脑发送电流的电脉冲。
Doctors involved in DBS say the impulses help because the brain uses electricity to send signals.
参与DBS的医生表示，这种脉冲有帮助，因为大脑使用电来发送信号。
In normal brains, Kopell said, electrical activity spreads through the brain unblocked to all areas. In depression, he said, the brain's emotional signals get blocked. He compared the problem to dancing. He said DBS seems to "unstick the circuit," permitting the brain to do what it normally would. A circuit is the path unblocked electrical current takes.
科佩尔说，在正常的大脑中，电活动通过大脑畅通无阻地传播到所有区域。他说，在抑郁症中，大脑的情绪信号被阻断了。他把这个问题比作跳舞。他说，DBS似乎“解开了回路”，允许大脑做它通常会做的事情。电路是电流畅通的路径。
Hollenbeck said the effect on her was almost immediate.
霍伦贝克说，这对她的影响几乎是立竿见影的。
"The first day after surgery, she started feeling a lifting of that negative mood, of the heaviness," said her psychiatrist, Dr. Martijn Figee.
“手术后的第一天，她就开始感觉到负面情绪和沉重感有所缓解，”她的精神科医生马丁·菲吉说。
For Hollenbeck, the biggest change was finding pleasure in music again.
对霍伦贝克来说，最大的变化是再次在音乐中找到乐趣。
She wishes her treatment had been available for her parents.
她希望她的父母也能接受这种治疗。
The treatment's history
治疗的历史
DBS research has continued for at least 20 years. Brain expert Dr. Helen Mayberg led early research that was called promising. But large studies launched more than 12 years ago saw no difference in treated and untreated groups.
星展银行的研究已经持续了至少20年。大脑专家海伦·梅伯格博士领导的早期研究被称为有希望的。但12年前开展的大型研究发现，治疗组和未治疗组之间没有差异。
Dr. Katherine Scangos is a psychiatrist at the University of California, San Francisco. She is also researching DBS and depression. She said there could be two reasons for the major studies showing no effect.
凯瑟琳·斯坎戈斯博士是加州大学旧金山分校的精神病学家。她也在研究脑起搏器和抑郁症。她说，主要研究显示没有效果可能有两个原因。
She said one reason was that the treatment was not "personalized" for each individual in the two studies. The second was that researchers looked at outcomes over just a few weeks.
她说，其中一个原因是，在这两项研究中，治疗并不是针对每个人的“个性化”。第二，研究人员只观察了几周的结果。
Recent research has shown more promising results for depression. A 2022 study said that on average 60 percent of depression patients showed improvement with DBS. A study from 2023 said that after six months of targeted DBS treatment, 90 percent of subjects showed improvements. Seventy percent were no longer considered medically depressed.
最近的研究显示了治疗抑郁症的更有希望的结果。2022年的一项研究表明，平均60%的抑郁症患者在接受DBS治疗后有所改善。2023年的一项研究表明，经过六个月的定向DBS治疗，90%的受试者表现出改善。70%的人不再被认为患有医学上的抑郁症。
Treatments being tested by teams today target individual patients more closely. The team at Mount Sinai, for example, is using brain imaging to find the right place to put electrodes in the brain.
如今，团队正在测试的治疗方法更密切地针对个体患者。例如，西奈山的研究小组正在利用脑成像技术寻找在大脑中放置电极的合适位置。
Mayberg is also with Mount Sinai. She said, "Everybody's brain is a little different, just like people's eyes are a little further apart or a nose is a little bigger or smaller."
Mayberg也在西奈山工作。她说:“每个人的大脑都有一点不同，就像人们的眼睛稍微分开一点，鼻子稍微大一点或小一点。”
Looking ahead
展望未来
Medical devices manufacturer Abbott Laboratories is launching a large clinical trial on patients this year, ahead of a possible decision by the FDA.
医疗设备制造商雅培实验室今年将在FDA可能做出决定之前，对患者进行一项大型临床试验。
Scangos said: "I'm hoping we will have approval within a short time."
Scangos表示:“我希望我们能在短时间内获得批准。”
But some doctors have concerns. They point to possible dangers of having a brain operation, which include bleeding, stroke and infection.
但一些医生对此表示担忧。他们指出了脑部手术可能存在的危险，包括出血、中风和感染。
Dr. Stanley Caroff is a professor of psychiatry at the University of Pennsylvania. He said scientists do not know the exact pathways or systems in the brain that produce depression. That makes it difficult to send the impulses to the right place.
斯坦利·卡洛夫博士是宾夕法尼亚大学的精神病学教授。他说，科学家们并不知道大脑中产生抑郁症的确切途径或系统。这使得很难将冲动发送到正确的地方。
"I believe from a psychiatric point of view, the science is not there," he said of DBS for depression.
“我相信，从精神病学的角度来看，科学并不存在，”他谈到DBS治疗抑郁症时说。
Moving forward
前进
Hollenbeck said DBS has not cured her. She still takes medicines for depression and needs ongoing care.
Hollenbeck说DBS并没有治愈她。她仍在服用治疗抑郁症的药物，需要持续的护理。
She recently visited Mayberg of Mount Sinai in her office and discussed recovery. "It's not about being happy all the time," Mayberg told her. "It's about making progress."
她最近去西奈山的梅伯格的办公室拜访了她，讨论了康复问题。“这并不是说要一直快乐，”梅伯格告诉她。“这是关于进步的。”
Researchers are studying the progress patients make. Recent research by Mayberg and others published in Nature said scientists can study brain activity to see how someone is doing at any given time.
研究人员正在研究患者的病情进展。梅伯格等人最近在《自然》杂志上发表的研究称，科学家可以通过研究大脑活动来了解一个人在任何特定时间的行为。
Study subjects can provide data from their homes about how they feel. Subjects answer questions and send data from their devices to researchers. They also send videos where researchers can observe speech and facial movements.
研究对象可以在家中提供有关自己感受的数据。受试者回答问题并将数据从他们的设备发送给研究人员。他们还发送视频，研究人员可以观察语音和面部动作。
Additionally, patients go to Mount Sinai so researchers can collect more information about their body movements. Hollenbeck, for example, is showing faster movements as her condition improves.
此外，病人去西奈山，这样研究人员就可以收集更多关于他们身体运动的信息。例如，随着病情的好转，霍伦贝克的运动速度加快了。
The data gained, combined with other information like life events, records how she is doing. This helps guide doctors' decisions about treatment, like increasing the amount of electricity used — which they did once.
所获得的数据，结合生活事件等其他信息，记录了她的行为。这有助于指导医生关于治疗的决定，比如增加用电量——他们曾经这样做过。
Hollenbeck showed AP the scars on her chest and head where doctors had placed the DBS devices. To her, they were signs of how far she had come.
Hollenbeck向美联社展示了她胸部和头部的伤疤，医生在那里放置了DBS装置。对她来说，这些标志着她已经走了多远。
She added, "...I'm able to see and remember, even on a bodily level, that I'm going to be OK."
她补充说:“……我能够看到并记住，甚至在身体层面上，我会没事的。”
