Helen S. Mayberg

American neurologist

Helen S. Mayberg (born 1956 in California), is an American neurologist. Mayberg is known in particular for her work delineating abnormal brain function in patients with major depression using functional neuroimaging. As of 2018, Mayberg holds positions as Professor of Neurology and Neurosurgery and Professor, Psychiatry and Neuroscience, both at Mount Sinai Medical School, and Professor of Psychiatry, Emory University; Emory University Hospital. Since 2018, she has served as Director, Nash Family Center for Advanced Circuit Therapeutics at the Icahn School of Medicine at Mount Sinai.

Mayberg's research in neurology came about through observations that the psychological diagnoses of mental disorders was not aided by, or backed up by, neurological evidence—and that developing a system of mapping the circuitry of brain activity would allow for more objective diagnoses and treatment. Mayberg studies depression and integrates neuroimaging strategies such as Positron emission tomography (PET), sMRI, fMRI, DTI, and EEG as well as behavioral and psychophysiological metrics to define brain mechanisms and testing of antidepressant treatments. She develops imaging biomarkers and algorithms that discriminate patient subgroups and optimize treatment selection in the management of individual patients across all stages of illness. She also concentrates on testing deep brain stimulation for treatment resistant depression, bringing together electro physiologists, engineers, imaging scientists and clinicians to refine, optimize and extend the treatment of depression and other neuropsychiatric disorders. Since the 1990s, electric stimulation of parts of the brain have been used to treat Parkinsons. The origins of DBS date back to the 1930s. One deep brain stimulation treatment for depression, developed by Mayberg and colleagues, placed electrodes in the Broadmann area 25 of the brain in severely depressed patients. Initial results were encouraging, though clinical trials were deemed futile and ultimately halted; however, there were positive changes in the success rate of the trial after the trial was halted. As a result, she resumed research on her hypothesis. Current research looks into why some patients respond to DBS and others do not. To this end, a study led by Dr. Mayberg showed that brief intraoperative exposure to therapeutic stimulation at the time of implantation surgery induces rapid and consistent electrophysiological brain state change—indexed by a decrease in Beta wave measured at the site of stimulation. These intraoperative brain state changes are seen in individual subjects and are correlated with a significant and sustained reduction in depressive symptoms outside of the operating room without additional stimulation, establishing reduction in beta power as a novel biomarker for DBS treatment optimization.

In 2017, Mayberg and the 14th Dalai Lama of Tibet attended a conference on mindfulness and the impact of meditation on the brain. The Dalai Lama was interested in whether the brain impacts the mind or if it might be the other way around. Mayberg pointed out the impact of DBS on severely depressed individuals. Their informal hypothesis was that, based on experiments that examined brain behavior from people practicing meditation, and experiments involving DBS, it was likely that meditation could improve brain waves that are important to mental health — yet when a patient experiences a certain degree of depression, it takes biological treatment to restore the patient to where they can meditate at all.

One issue surrounding DBS is that it stands to change a patient’s identity or cause other undesirable emotional or biological conditions. The rebuttal is that severely depressed individuals often have lost a sense of self and that invasive procedures can block the barrier that might be the root cause of the loss of self, thereby restoring it. Mayberg gave a presentation in 2014 at the Presidential Commission for the Study of Bioethical Issues, where she expressed her clinical and experiential lessons in neuroethics. Her commentary focused on how severely depressed patients are rarely irrational, and that there needs to be open communication and a two way understanding of expectations. She also asserted in publications that DBS patients should have their own words reflected in the medical literature.

Neurolaw, related to Neurocriminology, is based on the concept that MRI and PET scans as well as other means of examining of a person’s brain composition, can be used to hold harmless an alleged perpetrator in a court of law. Or, conversely, to justify a conviction. Adrian Raine was among those who postulated this theory in the 1980s, and it gained attention in the press after the trial and conviction of John Hinckley Jr.

Other scholars, including Mayberg, have argued in editorials and interviews that science of the brain cannot be used, at least at this point, to offer evidence for a conviction. By extension, it could be erroneously interpreted that brain analyses could predict a person’s potential for criminal behavior.

Mayberg is a member of the Governing Board of the International Neuroethics Society, the Institute of Medicine, the Dana Alliance and the NARSAD Scientific Advisory Board. She is active in the Society for Neuroscience, Society of Biological Psychiatry, American Neurological Association, American College of Neuropsychopharmacology, the Organization for Human Brain Mapping, and serves on the editorial boards of Human Brain Mapping (associate editor), NeuroImage, Clinical, Biological Psychiatry (ex officio editor), Brain Stimulation, Neuroinformatics, Neuromodulation (associate editor) and Brain Structure and Function.