Deep brain stimulation for major depression

T. E. Schlaepfer, B. H. Bewernick

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

A third of patients suffering from major depression cannot be helped by conventional treatment methods. These patients face reduced quality of life, high risk of suicide, and little hope of recovery. Deep brain stimulation (DBS) is under scientific evaluation as a new treatment option for these treatment-resistant patients. First clinical studies with small samples have been stimulated at the subgenual cingulate gyrus (Cg25/24), the anterior limb of the capsula interna (ALIC), and the nucleus accumbens (NAcc). Long-term antidepressant effects, augmentation of social functioning, and normalization of brain metabolism have been shown in about 50% of patients. Cognitive safety regarding attention, learning, and memory has been reported. Adverse events were wound infection, suicide, and hypomania, amongst others. Larger studies are under way to confirm these preliminary encouraging results. New hypothesis-guided targets (e.g., medial forebrain bundle, habenula) are about to be assessed in clinical trials. The application of DBS for other psychiatric diseases (e.g., bipolar disorder, alcohol dependency, opioid addiction, schizophrenia) is debated and single case studies are under way. Standards are needed for study registration, target selection, patient inclusion and monitoring, and publication of results to guarantee safety for the patients and scientific exchange.

Original languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages235-243
Number of pages9
DOIs
StatePublished - Jan 1 2013

Publication series

NameHandbook of Clinical Neurology
Volume116
ISSN (Print)0072-9752

Keywords

  • Anterior limb of internal capsule
  • Deep brain stimulation
  • Ethical standards
  • Major depression
  • Medial forebrain bundle
  • Neuromodulation
  • Nucleus accumbens
  • Reward system
  • Subgenual cingulate gyrus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Schlaepfer, T. E., & Bewernick, B. H. (2013). Deep brain stimulation for major depression. In Handbook of Clinical Neurology (pp. 235-243). (Handbook of Clinical Neurology; Vol. 116). Elsevier B.V.. https://doi.org/10.1016/B978-0-444-53497-2.00018-8