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Current Psychiatry Reviews

Editor-in-Chief

ISSN (Print): 1573-4005
ISSN (Online): 1875-6441

Update on Deep Brain Stimulation for Treatment-Resistant Depression

Author(s): Maria J. Portella, Dolors Puigdemont, Enric Alvarez and Victor Perez

Volume 8, Issue 3, 2012

Page: [175 - 182] Pages: 8

DOI: 10.2174/157340012800793000

Price: $65

Abstract

Major depression is one of the leading causes of disability worldwide since it is often accompanied by high rates of resistance to treatment. Up to 40% of patients do not remit after two adequate pharmacological tryouts (as indicated by STAR*D study). Poor efficacy of drugs for treatment-resistant depression (TRD) has prompted investigation of alternative treatment strategies.

Deep Brain Stimulation (DBS) involves the high-frequency electrical stimulation of stereotaxically implanted electrodes in certain brain regions. Various target areas have been examined for DBS to modulate cortico-limbic circuits, including the anterior limb in the internal capsule, the ventral capsule / ventral striatum (VC/VS), the nucleus accumbens (NAc), and the subgenual cingulate gyrus (SCG, Cg25).

DBS for treatment-resistant depression is showing promising results in the few studies published to date, and could potentially open new therapeutic opportunities as an effective long-term treatment strategy with low adverse effects for such a chronic, refractory population.

Keywords: Deep Brain Stimulation, DBS, Treatment-Resistant Depression, TRD, Subgenual Cingulate Gyrus, Nucleus Accumbens, Ventral Striatum, antidepressant, Neuromodulating, orbitofrontal

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