Deep Brain Stimulation and Its Effects on Schizophrenia

May 1, 2023 | Ashley Chen | Psychology

The Case Study of Gerald.

Gerald, of undisclosed race and age, was diagnosed with paranoid schizophrenia. In his interview, he described how he felt terrified entering the room, fearing that he was being led to be jailed, killed, or electrocuted. During his interview, Gerald said a bunch of odd or out of left field statements like “pictures got a headache” which makes no sense. He exhibited that of a movement disorder, shown by repeatedly playing with his hair, making repeated and unnecessary gestures. Gerald also constantly described a hallucination of his that he believed to be true. He believed that he was stabbed in the neck by a colored kid every time he would raise his hand in middle school. He also believed that he was *TW warning* raped 5 times during kindergarden.

This case study just goes to show how terrifying life can be with schizophrenia. Gerald’s one of the 3.2 million people in the US have been diagnosed with schizophrenia and 1.5 million people will be diagnosed with schizophrenia annually. Unfortunately, there have been no complete treatments for schizophrenia, except medication. But not everyone has the same response to medication. People immune to schizophrenia just have to live life like this. But…is there some sliver of hope to those who don’t respond well to medication?

Schizophrenia: The Symptoms.

Let’s talk about schizophrenia. Gerald’s case study pretty much established the baseline for what schizophrenia looks like and feels like. Constant paranoia, confusion, random bursts of energy, anger, and childlike behavior. People diagnosed with schizophrenia usually exhibit 4 different symptoms. The first one being delusions.

Schizophrenic delusions usually involve someone chasing, targeting, or watching them. People with these delusions commonly believe they’re being chased, tormented or punished in their everyday lives. Another type of delusion is the belief that something bad is going to happen to the world. For example, the prophecy that the world was going to end in 2012, could be very similar to what schizophrenics believe.

Another related symptom is hallucinations. While delusions are the belief that something bad is happening, hallucinations are tied to senses. Seeing people and things that aren’t there, hearing voices being the most common among schizophrenics. The voices that schizophrenics reported hearing could range from the devil inside your head being voiced, to a dead family member reincarnated.

Commonly, these psychological symptoms come with physical anomalies. Repetitive motions like fidgeting, rocking around, playing with hair, tapping, and others. More serious cases of schizophrenia can lead to extreme disorganized thinking and motor behavior. Disorganized thinking is the inability to form a train of thoughts or organize thoughts. Disorganized motor behavior describes times where schizophrenics lash out with extreme anger, or act childish. Schizophrenics can never control these outbursts and are constantly fearing the next.

Schizophrenia: The Causes.

Why does schizophrenia happen? Scientists haven’t found a single cause for schizophrenia. Like many other neurological disorders, it can be caused by many things. Genetics happen to play a role in the likelihood. If your family has a history of schizophrenia, you have a 20–30 percent likelihood of schizophrenia in later life. That percentage gets raised to 40 percent if both your parents have schizophrenia. Another possibility scientists are studying is the brain physicality itself. The differences in size, and shape. They found that people with schizophrenia had larger spaces in the brain called ventricles. Their medial temporal lobes, the parts of the brain that deal with memory, were smaller, and there were fewer connections between brain cells. People with schizophrenia commonly have a lack of active, or too active neurotransmitters (brain chemicals for short). The neurotransmitters in charge of this are called dopamine and glutamate. Dopamine is most likely responsible for delusions and hallucinations. Schizophrenics have too much dopamine released, causing overactive imagination and distortions of reality. Glutamate is mainly in charge of memories, perception, and motivation. This neurotransmitter can alter long term memories and perception of reality. This is the most studied and profound theory on why schizophrenia happens. Hallucinative drugs like LSD, MDMA, and methamphetamine can also contribute to later schizophrenia.

Below are some examples of brain scans comparing schizophrenic, healthy and high risk patients.

The Technology: Deep Brain Stimulation.

So, back to the beginning, what’s this technology to bypass schizophrenia? Deep brain stimulation. Now that’s probably something you’ve never heard before. Deep brain stimulation is a surgical operation where electrodes are implanted into certain areas of the brain to generate normal brain activities or functions. These implants emit brain waves to help regulate brain activities. Deep brain stimulation is being used to treat Parkinson’s disease, ADHD, OCD, and movement disorders. Deep brain stimulation has 3 main components and requires some surgery. The first part of the surgery is the electrode, which is a thin insulated wire inserted through a small opening in the skull and implanted into that brain area. The second part is the extension wire, which passes through the skin of the head, neck and shoulder, and connects the electrode to an internal pulse generator. The internal pulse generator, IPG, is implanted under the skin in the upper chest. Unfortunately, these are very invasive forms of EEG.

According to this article from John Hopkins, deep brain stimulation is a way to relieve schizophrenia symptoms. It’s not a cure, since the only cure for most neurological diseases is heavy medication thus far, but it is a good way to improve quality of life for people dealing with schizophrenia. There was one case study on this subject, so this treatment is still a work in progress, but this case study was proven to be very successful. This case study was worked on by an assistant professor at John Hopkins, Nicola Cascella, and he stated that “Deep brain stimulation could be a game changer for schizophrenia patients who don’t respond to medication,”

In the study, Cascella and his team, studied and treated a 35 year old Caucasion women, who had paranoid schizophrenia, alongside obsessive compulsive disorder (OCD). Her conditions were tormenting her relentlessly, and she was unaffected by drugs or prescribed medication. After a year of implanting the devices, and treatment using deep brain stimulation, she stated to have no side effects. Immediately, she stated that the hallucinations had immediately and completely disappeared.

Deep brain stimulation is being used, but needs to be studied more for the specific case of schizophrenia. I think it’s a neurological technology worth investing and researching in, along with how to make these implants more affordable, and less invasive. Deep brain stimulation unlocks a bunch of hope for not just schizophrenia, but other neurological disorders as well. One day, Gerald and 3.2 million other people won’t have to suffer, thanks to technologies like BCIs, EEGs, and more.