"A small study suggests that deep brain stimulation which is currently being investigated as a treatment for general depression may also help patients with bipolar disorder.    There are some caveats. The surgery necessary to allow deep brain stimulation is extremely expensive. And for now the research is preliminary so its too early to know for sure if the treatment is appropriate to be used for any kind of depression.    Still the study suggests that brain stimulation not only just helps patients who havent been able to recover from depression but it seems to be associated with the absence of relapses. Theyre not only getting better theyre staying better said study coauthor Dr. Helen Mayberg a professor in both the departments of psychiatry and behavioral sciences and neurology at Emory University School of Medicine in Atlanta.    In deep brain stimulation surgeons insert wires into the brain that allows a specific region to be continuously hit with an electronic pulse. The level of stimulation is controlled by a pacemakerlike device implanted in the chest.    Deep brain stimulation has been around for more than  years Mayberg said and is commonly used to treat Parkinsons disease. The cost of the surgery is about  she said.    Previous research by Mayberg and others suggested that deep brain stimulation had potential as a treatment for depression. The St. Jude Medical Neuromodulation company which has provided consulting fees to Mayberg and some of the other study authors is currently recruiting patients for a study that could pave the way for its approval as a treatment for depression Mayberg said.    The new study which appears online Jan.  in the Archives of General Psychiatry began with  patients with depression and seven with bipolar disorder  a condition that causes severe mood swings and is also known as manic depression. They all received deep brain stimulation for  weeks after going through four weeks either with or without stimulation.    Most of the patients continued to receive the treatment over two years although researchers temporarily turned it off in three of them as part of the study before realizing that doing so caused their depression to return.    The researchers found that  percent of patients went into remission after  weeks  percent of  patients after one year. After two years of the  patients still in the study seven patients  percent were in remission.    The number of patients who got better increased over time but its not quite clear as to why Mayberg said. The workings of deep brain stimulation as a whole are a mystery although Mayberg said it may work by changing the brains rhythms.    Patients didnt suffer from side effects she noted.    So whats next    Dr. Samuel James Collier an assistant professor of psychiatry at the University of Texas Southwestern Medical Center at Austin predicted that even if deep brain stimulation turns out to be an effective treatment for depression itll be far from the first line of defense.    Medications and ECT  electroconvulsive therapy  are clearly safer better tolerated and do not embody a large surgical risk Collier said. I cant think of a scenario where deep brain stimulation would be considered even remotely before medications and ECT were exhausted.    Still he said its important to note that we seem to be making progress and hopefully those who are suffering the most can find solace in that and not give up hope.    For now research continues. If patients are interested in deep brain stimulation treatment they should try to get into the study thats ongoing Mayberg said. More information For more about deep brain stimulation http visit the U.S. National Library of Medicine. SOURCES Helen S. Mayberg M.D. professor departments of psychiatry and behavioral sciences and neurology Emory University School of Medicine Atlanta Samuel James Collier M.D. assistant professor of psychiatry University of Texas Southwestern Medical Center at Austin Jan.   Archives of General Psychiatry online"