Brain surgery for severe depression is now available to patients in Colombia; who is eligible?

Dr. William Omar Contreras López performed the first Deep Brain Stimulation (DBS) surgery to treat a severe case of depression in Colombia.

The important intervention was performed at the International Hospital of Colombia (HIC) on a 38-year-old woman, who had been diagnosed more than two decades ago with a mixed condition of depression and anxiety.

The surgery was performed after the Colombian patient had undergone several types of treatments that had not yielded positive results.

Given the 38-year-old patient's condition, the doctor performed preliminary brain studies that determined the severity of her condition. The first surgery in Colombia was then performed, implanting electrodes the size of a grain of rice.

"Invasive surgery, which involves placing rice-sized electrodes in the brain, isn't the first time it's been performed in the world, but it is the first time four electrodes have been used," Dr. Contreras said.

The doctor clarified that the results of the procedure are "not" a definitive cure for depression. The goal is to offer patients an alternative that improves their quality of life.

"We don't cure anything, but we do improve the patient's quality of life. She can go out again, work, socialize, and feel interested in a partner," the doctor explained about the patient's procedure.

As EL TIEMPO reported, the first patient treated with this surgery in Colombia was Lorena Rodríguez, 38 , from Boyacá . The woman was diagnosed more than 17 years ago with a mixed anxiety and depression disorder.

Since being diagnosed, the patient has undergone six types of treatments to try to control the disorder.

Lorena Rodríguez requested surgery after her medications were no longer effective, to prevent the disorder from seriously affecting her daily routine.

According to the doctor's statement to EL TIEMPO, patient Lorena Rodríguez underwent a lengthy preparation process. "We went through a two-year process to determine whether we could actually perform the procedure."

Dr. William Omar Contreras López told this newspaper that there are currently around 280 million people in the world who suffer from depression, and approximately 30% of them do not seek medical treatment .

The surgeon explains that surgery is considered the last resort for addressing the disorder when a person cannot be treated with conventional medical options.

These are cases in which the diagnosis determines that the patient is eligible for surgical intervention.

"Patients have the right to surgery through their EPS, as long as they meet the clinical requirements and pass through the medical committee. The problem is that many don't know this exists, and sometimes even the treating physicians don't refer them," according to Dr. Contreras.

Deep Brain Stimulation (DBS) involves the implantation of " four electrodes" located in different deep regions of the brain, installed through perforations made at specific points in the skull.

Each procedure is approximately 4 millimeters deep and is performed while the patient is awake and lying on a stretcher.

Before the final device implantation is performed, a preliminary study is performed to record and analyze the electrical activity of neurons in the specific area to be treated.

In order to undergo surgery, the patient must undergo preparation that includes brain imaging studies using tractography , a technique that allows for mapping the emotional circuits affected in the brain.

Mood changes can vary from a period of 2 weeks to 2 years, in order to appreciate the results.

According to the Mayo Clinic , depression is classified as a disorder that can affect the physical and emotional stability of people, decreasing their performance in various areas of life.

Having this condition can cause sudden changes in sadness, outbursts of anger, and strong emotional swings, affecting people's physical well-being— from their ability to sleep to a constant buildup of fatigue.

According to the clinic, the diagnosis is determined through physical examinations, laboratory tests, and psychiatric evaluations.

Memory problems, physical pain, constant mood swings , and suicidal thoughts may be identified, if the patient experiences them.

LATEST NEWS EDITORIAL