Developing therapies for troubled brains
Dr. Horacio Capote is enamored with the troubled brain. The medical director of the Division of Neuropsychology at the Dent Neurologic Institute has a patient load that includes those with Alzheimer’s and Parkinson’s diseases, as well as a variety of mood disorders.
Depression alone is perplexing, he said, and so different from a condition like diabetes, which can be diagnosed with a simple blood test.
“We’re getting there,” he said, “but we don’t have it yet, so we lump different symptoms together and put them in these categories and make believe to ourselves that the DSM (mental health disorders guide) is the bible. In reality, underneath any one diagnosis, there’s a lot of heterogeneity. It’s not homogeneous. So as we begin to parse out the different subgroups of mental illness … I think we’ll be able to direct our treatments toward those subgroups.”
Capote, 54, of Amherst, is Cuban-born and grew up in Miami. He met his wife, Eileen, a Poughkeepsie native, while the two were in medical school at Universidad Autonoma de Guadalajara, in Mexico. They came to Buffalo for their residencies and stayed. His wife is an Amherst-based pediatrician.
Capote spends workdays at the Dent building in Amherst, conducting research and treating patients. He and his staff of two fellow doctors and four physician assistants use several ways to tackle depression untouched or barely helped by prescription medications. They include Electroconvulsive Therapy (ECT), a procedure that produces controlled seizures in a patient’s brain to clear the dark clouds of the disorder, and Transcranial Magnetic Stimulation (TMS), which uses focused magnetic pulses to stimulate key neurons to do the same.
“We also have probably two dozen patients with vagul nerve stimulators,” he said. “It’s a little pacemaker connected to the vagus nerve (that goes from your brainstem to your chest) and every five minutes electrical impulses get sent to the brain for 30 seconds. It’s like a pacemaker for the brain. We have a couple of patients with deep brain stimulators, who have electrodes inside the brain bilaterally. They have depression that is very difficult to treat. And we are working on an intravenous ketamine program.
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