Depression Research Supports Dual-Brain Theory

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Report: Depression Research Supports Dual-Brain Theory

Researchers have uncovered evidence that illnesses, such as depression, are associated with one half of the brain and that by activating the brain's healthier other half, a person's condition may improve. The report appears in this month's (march 2002) Neuropsychiatry, Neuropsychology, and Behavioral Neurology.

"If you activate the healthier hemisphere, you may help the person. If you activate the hemisphere where the troubles were, you make it worse," Fredric Schiffer, M.D., an associate attending psychiatrist at McLean Hospital, told MHW.

According to Schiffer, who is working with researchers at other institutions on this research, severely depressed patients' spirits were lifted when they received visual stimuli primarily to the healthy left side of the brain, and their mood improved significantly when their left hemispheres were treated with a more powerful form of stimulation, involving electromagnetic fields (TMS).

In a healthy person, the two parts of the brain work together in harmony; however, in people suffering with an illness like depression, one hemisphere may sabotage or dominate the other.

Schiffer said this latest report supports his earlier theory developed several years ago, which found that each half of the healthy brain houses a separate emotional mind. At that time, he found that he could elicit positive emotional responses from depressed patients by restricting their visual stimuli to one hemisphere.

He equipped his patients with goggles that restricted their visual stimuli to the right field of vision. He found that the goggles directed stimuli mostly to the left hemisphere, because signals from the right field of vision travel primarily to the opposite side of the brain.

Schiffer's depressed patients reported feeling better when visual stimuli was directed primarily to their left hemisphere, which suggested their right hemispheres were functioning abnormally. To develop a stronger approach to stimulating the healthier left hemisphere of the brain, Schiffer began working with Alvaro Pascual-Leone, MD, Ph.D., a researcher at Boston's Beth Israel Deaconess Medical Center, who developed a method of stimulating the brain using electromagnetic fields, called transcranial magnetic stimulation (TMS).

Schiffer and Pascual-Leone suspected that the TMS method benefited only 50 percent of depressed patients. They suspected that those patients were the ones whose healthy hemispheres were being stimulated. They embarked on an experiment to determine if those patients could be identified in advance by Schiffer's goggle test.

When they channeled visual stimuli primarily to the left side of 37 depressed patients for 45 seconds and then to their right side for the same time, they found that 20 patients reported feeling better when stimuli were directed to the left side of the brain, suggesting it was the healthier hemisphere. Fifteen patients felt worse, which suggested the right half of their brain was healthier. The patients subsequently received a two-week course of TMS treatments only to the left hemisphere.

The patients' depression levels were tested prior to wearing the goggles and tested again two weeks after the last of a series of TMS treatments using a standard measure, called the Hamilton Depression Rating Scale (HDRS).

Under the HDRS measure, higher scores are associated with higher levels of depression. The researchers found that the 20 patients who felt more improvement with the left hemisphere visual stimulation experienced a median 42 percent reduction in HDRS. A fifty-percent reduction is considered remission. The average reduction for the second group of 15 patients who felt worse was only 11 percent, which is considered below the failure mark.

Schiffer said the study could be used to fortify current TMS procedures by predicting which individuals with depression will most likely benefit. "In addition, this study bolsters my dual-brain hypothesis," said Schiffer.

Schiffer said he uses goggles with positive results in his clinical practice and as an adjunct to psychotherapy. He said he intends to take his approach a step further by using functional MRI to study how the brain changes with goggle use. Schiffer said the functional image will help them determine if the goggle activates one hemisphere more than the other.

Report: Depression Research Supports Dual-Brain Theory

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