好英语网大脑植入装置或可帮助治疗严重抑郁症
An electrical implant that sits in the skull and is wired to the brain can detect and treat severe depression, US scientists believe after promising results with a first patient.
美国科学家在第一位患者身上所作试验取得令人满意的结果后相信，一种植入大脑的电子装置可以侦测和治疗严重抑郁症。
Sarah, who is 36, had the device fitted more than a year ago and says it has turned her life around.
这名患者名叫莎拉，36岁，之前患有严重抑郁症。接受大脑电子植入装置治疗一年多后，她说，生活得到彻底改变。
凯瑟琳·斯坎戈斯教授检查莎拉的装置和进步 。
The matchbox-sized pack in her head is always "on" but only delivers an impulse when it senses she may need it.
莎拉大脑的电子植入物像一个火柴盒般大小，永远处于开机状态，但只有当它感觉有需要时才发送脉冲信号。
The experimental study is described in Nature Medicine journal.
这项研究结果发表在《自然医学》杂志上。
The researchers, from University of California, San Francisco, stress it is too soon to say if it might help other patients, like Sarah, with hard-to-treat depression, but they are hopeful and plan more trials.
美国加利福尼亚大学旧金山分校的研究人员强调，现在就说它能否可以帮助治疗像莎拉这样有抑郁顽疾的其他患者还为时过早，但他们充满信心，并计划进行更多的试验。
Depression circuits
抑郁症电路图
Sarah is the first person to have had the experimental therapy.
莎拉是接受这一试验疗法的第一人。
She'd had a succession of failed treatments, including anti-depressants and electroconvulsive therapy in recent years.
之前她曾吃过抗抑郁药物，最近几年接受电痉挛疗法（electroconvulsive therapy），但都以失败告终。
The surgery may sound daunting, but Sarah said the prospect of gaining "any kind of relief" was better than the darkness she had been experiencing.
通过外科手术在大脑植入电子装置听起来有些吓人，但莎拉说，有望获得“任何一点解脱”都要好过她所经历的黑暗痛苦。
"I had exhausted all possible treatment options.My daily life had become so restricted. I felt tortured each day. I barely moved or did anything."
“我尝试了所有治疗方法。我每一天都饱受磨难，几乎很少活动，或是做任何事，”莎拉说。
The surgery involved drilling small holes in her skull to fit the wires that would monitor and stimulate her brain.
医生需要在莎拉头骨上钻两个小孔，安装可以监视和刺激她大脑的线路。
The box, containing the battery and the pulse generator, was tucked into the bone, beneath her scalp and hair.
装有电池和脉冲发射器的小盒子则被嵌在她头皮和头发下的颅骨中。
The procedure took a full working day and was done under general anaesthetic, meaning Sarah was unconscious throughout.
手术需要一整天，而且需要全身麻醉，莎拉在整个过程中毫无知觉。
Sarah says when she woke, up she felt euphoric.
莎拉说，手术醒来后有一种欣快的感觉。
"When the implant was first turned on, my life took an immediate upward turn. My life was pleasant again."
她说，“电子装置第一次开启时，我的生活立即出现好转。生活又变好了。”
"Within a few weeks, the suicidal thoughts disappeared."
“几周之内，自杀念头就消失了。”
"When I was in the depths of depression all I saw is what was ugly."
“当我深度抑郁时，我看到的一切都是丑陋的。”
A year on, Sarah remains well, with no side-effects.
一年后，莎拉仍然感觉良好，没有副作用。
"The device has kept my depression at bay, allowing me to return to my best self and rebuild a life worth living."
莎拉表示，大脑电子装置让她摆脱抑郁症，并让她处于最佳状态，重建生活。
She can't feel the device as it fires, but says: "I could probably tell you within 15 minutes that it has gone off because of a sense of alertness and energy or the positivity I will feel."
她说，植入的装置发射信号时自己感觉不到。但是，“在信号停止后的15分钟内能有所察觉，因为这时会感觉非常清醒，或者感到一种正能量。”
How it works
工作原理
Researcher Dr Katherine Scangos, who is a psychiatrist at the university, said the innovation was made possible by locating the "depression circuits" in Sarah's brain.
研究人员斯坎戈斯博士也是加州大学的精神病学家。她说，这一创新疗法之所以成为现实可能是因为他们找到了莎拉大脑中的“抑郁回路”。
"We found one location, which is an area called the ventral striatum, where stimulation consistently eliminated her feelings of depression.
斯坎戈斯博士表示，他们找到了一个叫腹侧纹状体（ventral striatum）的位置， 通过不断刺激该部位可以消除莎拉的抑郁感。
"And we also found a brain activity area in the amygdala that could predict when her symptoms were most severe."
“我们还在大脑杏仁核内发现一个大脑活动区，这一区域可以预测她的症状何时最严重，” 斯坎戈斯博士说。
The scientists say a lot more research is needed to test the experimental therapy and determine if it can help more people with severe depression, and perhaps other conditions too.
科学家们说，他们需要对这一疗法进行更多研究，以确定它是否能帮助更多的严重抑郁症、或许还有其他一些病症的患者。
Personalised treatment
个性化治疗
Dr Scangos, who has enrolled two other patients in the trial and hopes to recruit nine more, said: "We need to look at how these circuits vary across patients and repeat this work multiple times.
斯坎戈斯博士在试验中已经招募了2名患者，并希望再招募9人。她表示，需要观察不同患者大脑回路有何差异，然后多次重复试验。
"And we need to see whether an individual's biomarker or brain circuit changes over time as the treatment continues.We didn't know if we were going to be able to treat her depression at all because it was so severe."
她说，“我们需要观察个体生化标志物或大脑回路是否会随着治疗继续而发生变化。由于她的抑郁如此严重，我们一开始根本不知道能否治疗她。”
"So in that sense we are really excited about this. It's so needed in the field right now."
因此，斯坎戈斯博士表示，从这一意义上来说，他们感到非常兴奋。因为这是目前这一领域非常需要的。
Dr Edward Chang, the neurosurgeon who fitted the device, said: "To be clear, this is not a demonstration of efficacy of this approach."
为莎拉装置电子设备的神经外科医生张复伦（Edward Chang）强调，需要说明的是，这并非是要证明这种方法的疗效。
"It's really just the first demonstration of this working in someone and we have a lot of work ahead of us as a field to validate these results to see if this actually is something that will be enduring as a treatment option."
他说，“这只是第一次展示在某人身上有效而已。在这一领域我们还有许多工作要做，才能证实它是否可以成为一个比较持久的治疗选项。”
Prof Jonathan Roiser, a neuroscience expert at University College London in the UK, said: "Although this kind of highly invasive surgical procedure would only ever be used in the most severe patients with intractable symptoms, it is an exciting step forward due to the bespoke nature of the stimulation.
英国伦敦大学学院的神经科学专家罗伊瑟教授表示，虽然这种高度创伤性外科手术只应该用于那些患有顽疾的重症患者 ，但刺激大脑的个性化特点代表着“向前迈出了令人兴奋的一步”。
"It is likely that if trialled in other patients, different recording and stimulation sites would be required, as the precise brain circuitry underlying symptoms probably varies between individuals.
罗伊瑟教授表示，如果在其他病人身上进行试验，很可能需要记录、刺激不同部位，因为不同症状的精确脑部回路可能会因人而异。
"As there was only one patient and no control condition, it remains to be seen whether these promising results hold in clinical trials."
他说，“由于只是一名患者，而且没有对照病例，因此，这些令人兴奋的结果是否能在临床试验中成立还有待观察。”