PMID- 19914605
OWN - NLM
STAT- MEDLINE
DCOM- 20100107
LR  - 20220409
IS  - 1873-2402 (Electronic)
IS  - 0006-3223 (Linking)
VI  - 67
IP  - 2
DP  - 2010 Jan 15
TI  - Nucleus accumbens deep brain stimulation decreases ratings of depression and 
      anxiety in treatment-resistant depression.
PG  - 110-6
LID - 10.1016/j.biopsych.2009.09.013 [doi]
AB  - BACKGROUND: While most patients with depression respond to combinations of 
      pharmacotherapy, psychotherapy, and electroconvulsive therapy (ECT), there are 
      patients requiring other treatments. Deep brain stimulation (DBS) allows 
      modulation of brain regions that are dysfunctional in depression. Since anhedonia 
      is a feature of depression and there is evidence of dysfunction of the reward 
      system, DBS to the nucleus accumbens (NAcc) might be promising. METHODS: Ten 
      patients suffering from very resistant forms of depression (treatment-resistant 
      depression [TRD]), not responding to pharmacotherapy, psychotherapy, or ECT, were 
      implanted with bilateral DBS electrodes in the NAcc. The mean (+/-SD) length of 
      the current episode was 10.8 (+/-7.5) years; the number of past treatment courses 
      was 20.8 (+/-8.4); and the mean Hamilton Depression Rating Scale (HDRS) was 32.5 
      (+/-5.3). RESULTS: Twelve months following initiation of DBS treatment, five 
      patients reached 50% reduction of the HDRS (responders, HDRS = 15.4 [+/-2.8]). 
      The number of hedonic activities increased significantly. Interestingly, ratings 
      of anxiety (Hamilton Anxiety Scale) were reduced in the whole group but more 
      pronounced in the responders. The [18F]-2-fluoro-2-deoxy-D-glucose positron 
      emission tomography data revealed that NAcc-DBS decreased metabolism in the 
      subgenual cingulate and in prefrontal regions including orbital prefrontal 
      cortex. A volume of interest analysis comparing responders and nonresponders 
      identified metabolic decreases in the amygdala. CONCLUSIONS: We demonstrate 
      antidepressant and antianhedonic effects of DBS to NAcc in patients suffering 
      from TRD. In contrast to other DBS depression studies, there was also an 
      antianxiety effect. These effects are correlated with localized metabolic 
      changes.
FAU - Bewernick, Bettina H
AU  - Bewernick BH
AD  - Department of Psychiatry and Psychotherapy, University Hospital, 53105 Bonn, 
      Germany.
FAU - Hurlemann, Rene
AU  - Hurlemann R
FAU - Matusch, Andreas
AU  - Matusch A
FAU - Kayser, Sarah
AU  - Kayser S
FAU - Grubert, Christiane
AU  - Grubert C
FAU - Hadrysiewicz, Barbara
AU  - Hadrysiewicz B
FAU - Axmacher, Nikolai
AU  - Axmacher N
FAU - Lemke, Matthias
AU  - Lemke M
FAU - Cooper-Mahkorn, Deirdre
AU  - Cooper-Mahkorn D
FAU - Cohen, Michael X
AU  - Cohen MX
FAU - Brockmann, Holger
AU  - Brockmann H
FAU - Lenartz, Doris
AU  - Lenartz D
FAU - Sturm, Volker
AU  - Sturm V
FAU - Schlaepfer, Thomas E
AU  - Schlaepfer TE
LA  - eng
SI  - ClinicalTrials.gov/NCT00122301
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Biol Psychiatry
JT  - Biological psychiatry
JID - 0213264
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Amygdala/diagnostic imaging
MH  - Brain Mapping
MH  - Deep Brain Stimulation/*methods
MH  - Depression/diagnostic imaging/pathology/physiopathology/*therapy
MH  - Female
MH  - Fluorodeoxyglucose F18
MH  - Gyrus Cinguli/diagnostic imaging
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neuropsychological Tests
MH  - Nucleus Accumbens/diagnostic imaging/*physiology
MH  - Positron-Emission Tomography/methods
MH  - Prefrontal Cortex/diagnostic imaging/physiopathology
MH  - Psychiatric Status Rating Scales
MH  - Treatment Outcome
EDAT- 2009/11/17 06:00
MHDA- 2010/01/08 06:00
CRDT- 2009/11/17 06:00
PHST- 2009/07/09 00:00 [received]
PHST- 2009/09/03 00:00 [revised]
PHST- 2009/09/11 00:00 [accepted]
PHST- 2009/11/17 06:00 [entrez]
PHST- 2009/11/17 06:00 [pubmed]
PHST- 2010/01/08 06:00 [medline]
AID - S0006-3223(09)01094-4 [pii]
AID - 10.1016/j.biopsych.2009.09.013 [doi]
PST - ppublish
SO  - Biol Psychiatry. 2010 Jan 15;67(2):110-6. doi: 10.1016/j.biopsych.2009.09.013.