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Personalized Brain Stimulation Could Restore Religious Faith
Could recent advances in neuromodulation be extended to resurrect faith?
Posted June 23, 2021 Reviewed by Gary Drevitch
Key points
- Personalized brain stimulation has shown promise for conditions such as epilepsy, Parkinson's Disease, intractable depression, and addiction.
- Dopaminergic circuits in the prefrontal cortex have been implicated in the loss of religious faith in some Parkinson's Disease patients.
- For patients who have lost this aspect of themselves, a neural prosthetic for religious faith could have a profound impact on quality of life.
Up to a third of adults with major depression suffer from symptoms that do not respond to treatment. Although some eventually find a treatment that works for them, approximately 10 to 15% of patients with major depression never respond to treatment and develop an increased lifetime risk of suicide.
Fortunately, scientists at UC San Francisco can offer some hope for such patients. Earlier this year, Katherine Scangos and colleagues reported a case study in Nature Medicine showing that targeted neuromodulation successfully relieved severe treatment-resistant depression symptoms.
As noted by Scangos:
Prior attempts to develop neuromodulation for depression have always applied stimulation in the same site in all patients, and on a regular schedule that fails to specifically target the pathological brain state. We know depression affects different people in very different ways, but the idea of mapping out individualized sites for neuromodulation that match a patient’s particular symptoms had not been well explored.
“The World Went from Shades of Dark Gray to Just — Grinning”
Sarah* was a 36-year-old woman with bouts of severe treatment-resistant depression since childhood. Her symptoms made it impossible to maintain a job or drive.
In Sarah, stimulation of several different brain sites for 90 seconds was found to reliably evoke an array of positive emotional states. For example, stimulation of a region called the orbitofrontal cortex (OFC) produced a feeling of calm pleasure she likened to “reading a good book.”
When longer stimulation times of up to 10 minutes were tested, stimulation surprisingly affected Sarah’s symptoms in different ways depending on her mental state at the time. When she had been feeling anxious, stimulation of the OFC was calming, but when Sarah felt decreased energy, OFC stimulation caused her to feel overly sleepy and worsened her mood. Different effects were also observed at different sites.
Sarah shared:
[W]hen they found the right spot, it was like the Pillsbury Doughboy when he gets poked in the tummy and has that involuntary giggle. I hadn’t really laughed at anything for maybe five years, but I suddenly felt a genuine sense of glee and happiness, and the world went from shades of dark gray to just — grinning.
For Sarah, stimulation of an area called the ventral capsule/ventral striatum was best at alleviating her primary symptoms of low energy and loss of pleasure in activities she once enjoyed. She recalled:
As they kept playing with that area, I gradually looked down at the needlework I had been doing as a way to keep my mind off negative thoughts and realized I enjoyed doing it, which was a feeling I haven’t felt for years.
Sarah continued:
It struck me so clearly in that moment that my depression wasn’t something I was doing wrong or just needed to try harder to snap out of; it really was a problem in my brain that this stimulation was able to fix. Every time they’d stimulate, I felt like, ‘I’m my old self, I could go back to work, I could do the things I want to do with my life.’
Investigators went on to implant a neuromodulation device in Sarah known as the NeuroPace RNS System — a device currently used to control seizures in epilepsy patients. For Sarah and other study participants, the device will be used to detect brain signature patterns that indicate a shift toward a highly depressed state and provide mild stimulation to counteract this mood shift.
Over five months after the NeuroPace device was implanted, Sarah continued to report that her symptoms had almost completely disappeared:
I can’t tell exactly when the device turns on, but I generally feel more of a sense of clarity, an ability to look at my emotions rationally and apply the tools that I’ve worked on through psychotherapy, and that is so far from where I was before
When the Brain Loses Faith
Frank* sat with his wife across from the neurologist in the VA Health Center. Frank was a distinguished older gentleman and a decorated World War II veteran. He continued to work as an engineering consultant but had been withdrawing from parts of his job and his personal life as his symptoms of Parkinson’s Disease (PD) progressed.
Frank’s wife explained that he hadn’t completely pulled away from things, “just social parts of his work, some physical stuff, and unfortunately his private religious devotions.”
The neurologist asked what she meant by “religious devotions.” She explained that Frank used to read his Bible and pray all the time but had been doing so less and less.
Frank shared that although he had been religious all his life, he had completely lost interest in religion. In fact, he said he wanted to believe but found it difficult to access his religious memories, experiences, and feelings. Despite being able to easily answer questions about religious doctrines and ideas, Frank said he now found faith “hard to fathom.”
This wasn’t an intellectual deficit, but a deficit in belief.
On the other end of the spectrum, I and many other individuals with bipolar disorder have experienced becoming hyper-religious, particularly during manic episodes. Since PD patients experience decreased dopamine in prefrontal circuits while bipolar mania drives a surfeit of the neurotransmitter in the same areas, it is compelling to think that dopamine may be the fuel for religiosity in the brain.
The Gift of God
In addition to treatment-resistant depression, individualized neuromodulation shows promise for other conditions involving complex cognitive and behavioral changes such as addiction. Such techniques have also been successful in treating the movement-related aspects of PD, so why not apply it to loss of function when it comes to religiosity? For patients who have lost this aspect of themselves and long for its return, a neural prosthetic for religious faith would have a profound impact on quality of life and sense of self.
And in the process, neuroscience may bring us closer to answering age-old epistemological questions about the nature of spirituality and faith.
* Not their real names.
References
Ergenzinger, E. (2021, Jan. 20). Personalized brain stimulation provides hope for treating intractable depression. Being Well, https://medium.com/beingwell/personalized-brain-stimulation-provides-hope-for-treating-intractable-depression-ca51d77668bd.
Ergenzinger, E. (2021, May). Divining disorder. Psychology Today, https://www.psychologytoday.com/us/articles/202105/divining-disorder.
Grafman, J., Cristofori, I., Zhong, W., & Bulbulia, J. (2020). The Neural Basis of Religious Cognition. Current Directions in Psychological Science, 29(2):126-133, DOI: 10.1177/0963721419898183.
Koenig H.G. (2007). Religion, Spirituality, and Psychotic Disorders. Revista de Psiquiatria Clínica, 34(1):40-48, DOI: 10.1590/S0101-60832007000700013.
Scangos, K.W., Makhoul, G.S., Sugrue, L.P. et al. (2021). State-dependent responses to intracranial brain stimulation in a patient with depression. Nat. Med. 27:229–231, DOI: 10.1038/s41591-020-01175-8.
