CU Anschutz researchers prepare for feasibility study exploring the neurosurgical therapy for treatment-resistant cases
For 40 years, advancing treatments for schizophrenia has been a goal for Judith Gault, PhD. Watching her father struggle with the serious mental health disorder, which can rob people of their sense of reality and severely disrupt their lives, continues to motivate her work.
Now, recent successes with deep brain stimulation (DBS) have placed that goal within reach for Gault, an associate research professor of neurosurgery at the University of Colorado Anschutz School of Medicine.
She and her team of psychiatrists and neuroscientists recently received conditional approval from the FDA under an investigational device exemption (IDE) for an early feasibility study in treatment-resistant schizophrenia (TRS) and schizoaffective disorder (SAD).
"I'm very familiar with how difficult it is for people and their families to navigate and find effective care for schizophrenia and schizoaffective disorder," said Gault, who has since lost her dad. "Antipsychotics are amazing, and they help most people significantly. Even those refractory to antipsychotics still benefit from them. But we still have a lot of room for improvement."
Current DBS uses:
- Parkinson's disease (reduces stiffness, slowness, tremors)
- Essential tremor (eases shaking)
- Dystonia (relieves involuntary muscle contractions)
- Epilepsy (reduces number of seizures)
About 10-23% of patients have moderate to severe symptoms despite trying different antipsychotics including clozapine, the best antipsychotic for TRS. DBS could help alleviate some of the treatment challenges, but larger clinical trials are imperative to determine safety and effectiveness.
What are the gaps in current schizophrenia treatment?
"We've had antipsychotics for over 70 years now," Gault said. "And despite their availability and the fact that people are taking them, the life expectancy for people with schizophrenia is still decreased by about 17 years on average."
Unemployment and incarceration rates of people with schizophrenia are 20 times higher than the general population, and an estimated 20% to 40% of people with the disorder will attempt suicide at least once in their lifetimes.
"We clearly are not meeting all the needs of people with schizophrenia."
If approved, the CU Anschutz study will be led by Rachel Davis, PhD, division head of adult psychiatry, and run in conjunction with a study already underway at Johns Hopkins University. Initial results treating patients with persistent auditory hallucinations are positive, with two cases published.
"One experienced complete and sustained resolution of their auditory hallucinations, and another person had a 64% reduction in their auditory hallucinations to make them more bearable," Gault said.
Schizophrenia symptoms may include:
- Delusions
- Hallucinations
- Paranoia
- Lack of drive
- Inability to feel joy
