PMID- 18842257 OWN - NLM STAT- MEDLINE DCOM- 20090410 LR - 20231024 IS - 1873-2402 (Electronic) IS - 0006-3223 (Print) IS - 0006-3223 (Linking) VI - 65 IP - 4 DP - 2009 Feb 15 TI - Deep brain stimulation of the ventral capsule/ventral striatum for treatment-resistant depression. PG - 267-75 LID - 10.1016/j.biopsych.2008.08.029 [doi] AB - BACKGROUND: We investigated the use of deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) for treatment refractory depression. METHODS: Fifteen patients with chronic, severe, highly refractory depression received open-label DBS at three collaborating clinical sites. Electrodes were implanted bilaterally in the VC/VS region. Stimulation was titrated to therapeutic benefit and the absence of adverse effects. All patients received continuous stimulation and were followed for a minimum of 6 months to longer than 4 years. Outcome measures included the Hamilton Depression Rating Scale-24 item (HDRS), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Global Assessment of Function Scale (GAF). RESULTS: Significant improvements in depressive symptoms were observed during DBS treatment. Mean HDRS scores declined from 33.1 at baseline to 17.5 at 6 months and 14.3 at last follow-up. Similar improvements were seen with the MADRS (34.8, 17.9, and 15.7, respectively) and the GAF (43.4, 55.5, and 61.8, respectively). Responder rates with the HDRS were 40% at 6 months and 53.3% at last follow-up (MADRS: 46.7% and 53.3%, respectively). Remission rates were 20% at 6 months and 40% at last follow-up with the HDRS (MADRS: 26.6% and 33.3%, respectively). The DBS was well-tolerated in this group. CONCLUSIONS: Deep brain stimulation of the VC/VS offers promise for the treatment of refractory major depression. FAU - Malone, Donald A Jr AU - Malone DA Jr AD - Department of Psychiatry and Psychology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA. maloned@ccf.org FAU - Dougherty, Darin D AU - Dougherty DD FAU - Rezai, Ali R AU - Rezai AR FAU - Carpenter, Linda L AU - Carpenter LL FAU - Friehs, Gerhard M AU - Friehs GM FAU - Eskandar, Emad N AU - Eskandar EN FAU - Rauch, Scott L AU - Rauch SL FAU - Rasmussen, Steven A AU - Rasmussen SA FAU - Machado, Andre G AU - Machado AG FAU - Kubu, Cynthia S AU - Kubu CS FAU - Tyrka, Audrey R AU - Tyrka AR FAU - Price, Lawrence H AU - Price LH FAU - Stypulkowski, Paul H AU - Stypulkowski PH FAU - Giftakis, Jonathon E AU - Giftakis JE FAU - Rise, Mark T AU - Rise MT FAU - Malloy, Paul F AU - Malloy PF FAU - Salloway, Stephen P AU - Salloway SP FAU - Greenberg, Benjamin D AU - Greenberg BD LA - eng GR - P50 MH086400/MH/NIMH NIH HHS/United States GR - R01 EY017658/EY/NEI NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20081008 PL - United States TA - Biol Psychiatry JT - Biological psychiatry JID - 0213264 SB - IM MH - Adolescent MH - Adult MH - Chronic Disease MH - Cognition/physiology MH - *Deep Brain Stimulation/adverse effects MH - Depressive Disorder/psychology/*therapy MH - Drug Resistance MH - Electrodes, Implanted MH - Female MH - Humans MH - Male MH - Middle Aged MH - Neostriatum/*physiology MH - Neuropsychological Tests MH - Psychiatric Status Rating Scales MH - Recurrence MH - Treatment Outcome MH - Young Adult PMC - PMC3486635 MID - NIHMS178330 COIS- Dr. Malloy reports no biomedical financial interests or potential conflicts of interest. EDAT- 2008/10/10 09:00 MHDA- 2009/04/11 09:00 PMCR- 2012/11/01 CRDT- 2008/10/10 09:00 PHST- 2007/11/12 00:00 [received] PHST- 2008/08/06 00:00 [revised] PHST- 2008/08/15 00:00 [accepted] PHST- 2008/10/10 09:00 [pubmed] PHST- 2009/04/11 09:00 [medline] PHST- 2008/10/10 09:00 [entrez] PHST- 2012/11/01 00:00 [pmc-release] AID - S0006-3223(08)01083-4 [pii] AID - 10.1016/j.biopsych.2008.08.029 [doi] PST - ppublish SO - Biol Psychiatry. 2009 Feb 15;65(4):267-75. doi: 10.1016/j.biopsych.2008.08.029. Epub 2008 Oct 8.