Marom Bikson interviews: Harold Sackeim on “Wired for Depression”. Part 5 of 5:VNS, DBS, drugs, BCI
Cite as: “Wired for Depression” with Harold Sackeim (2025) Neuromodec Journal. Marom Bikson, Harold Sackeim. doi.org/10.31641/nmj-PBRV4493
Summary: Marom Bikson interviews Harold Sackeim. Part 1: Foundations of ECT; Part 2: First modern ECT. Part 3: Developments in ECT. Part 4: Development of TMS. Part 5: Targeting the Future, VNS, DBS, drugs, BCI
Abstract: An interview in five parts of Harold Sackeim by Marom Bikson. Part 1: Electroconvulsive Therapy (ECT) as the first brain stimulation of psychiatric disorders. Laterality of mood and ECT. The concept of dose-titrated ECT
Part 2: Foundational study on dose-titration and montage-selective (RUL,BL) ECT, leading to improvement in side-effects. Role of electricity vs seizure in efficacy and side effects . ECT for status epilepticus and lesson on how the brain response to the seizure is the treatment. Why research on ECT is difficult.
Part 3: Brief vs Ultrabrief pulse ECT. Why do patients with depression relapse and why we are “wired for depression”? Durability of benefits from ECT and role of drugs. The anti-seizure mechanisms activate endogenous depression control circuity. Seizures are not sufficient. Why ECT is anti-seizure vs kindling in animals.
Part 4: More on “we are wired for depression” and what it means for treatment Emergence of Transcranial Magnetic Stimulation (TMS) for depression. Development of TMS technology for neurophysiology. Repeated TMS changes brain excitability. TMS to prefrontal cortex to treat depression and Mark George. Resistance to TMS for depression. Increasing TMS efficacy through dose improvement. Clinical trial methodology and sham control.
Part 5: Vagus Nerve Stimulation (VNS) bottom-up modulation, from epilepsy to depression. Regulatory history of VNS for depression and ongoing VNS trials. Deep Brain Stimulation. Relapse for slow acting vs fast acting therapies. Founding the Journal of Brain Stimulation. Technology as underpinning brain stimulation field. Targeted pharmacotherapy. Neuromodulation combined with drugs. Non-invasive deep brain stimulation (TI, Ultrasound). Brain Computer Interfaces (BCI), psychiatric biomarkers, and closed-loop brain stimulation.
Transcript at: https://neuromodec.org/marom-bikson-interviews-harold-sackeim-august-2025