A multicenter pilot study of subcallosal cingulate area deep brain stimulation for treatment-resistant depression

被引:257
作者
Lozano, Andres M. [1 ]
Giacobbe, Peter [2 ]
Hamani, Clement [1 ]
Rizvi, Sakina J. [2 ]
Kennedy, Sidney H. [2 ]
Kolivakis, Theodore T. [4 ]
Debonnel, Guy [4 ]
Sadikot, Abbas F. [3 ]
Lam, Raymond W. [6 ]
Howard, Andrew K. [6 ]
Ilcewicz-Klimek, Magda [6 ]
Honey, Christopher R. [5 ]
Mayberg, Helen S. [7 ]
机构
[1] Univ Toronto, Div Neurosurg, Toronto, ON M5S 1A1, Canada
[2] Univ Toronto, Dept Psychiat, Univ Hlth Network, Toronto, ON M5S 1A1, Canada
[3] McGill Univ, Dept Neurol & Neurosurg, Montreal, PQ, Canada
[4] McGill Univ, Dept Psychiat, Montreal, PQ H3A 2T5, Canada
[5] Univ British Columbia, Div Surg Neurosurg, Vancouver, BC V5Z 1M9, Canada
[6] Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada
[7] Emory Univ, Dept Psychiat, Atlanta, GA 30322 USA
基金
英国医学研究理事会; 加拿大健康研究院;
关键词
deep brain stimulation; depression; mood disorder; psychiatry; cingulate gyrus; subgenual cingulate; TRANSCRANIAL MAGNETIC STIMULATION; SUICIDAL-BEHAVIOR; MAJOR DEPRESSION; BLOOD-FLOW; DISORDERS; PREDICTORS; METABOLISM; SADNESS; MOOD;
D O I
10.3171/2011.10.JNS102122
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. Deep brain stimulation (DBS) has been recently investigated as a treatment for major depression. One of the proposed targets for this application is the subcallosal cingulate gyms (SCG). To date, promising results after SCG DBS have been reported by a single center. In the present study the authors investigated whether these findings may be replicated at different institutions. They conducted a 3-center prospective open-label trial of SCG DBS for 12 months in patients with treatment-resistant depression. Methods. Twenty-one patients underwent implantation of bilateral SCG electrodes. The authors examined the reduction in Hamilton Rating Scale for Depression (HRSD-17) score from baseline (RESP50). Results. Patients treated with SCG DBS had an RESP50 of 57% at 1 month, 48% at 6 months, and 29% at 12 months. The response rate after 12 months of DBS, however, increased to 62% when defined as a reduction in the baseline HRSD-17 of 40% or more. Reductions in depressive symptomatology were associated with amelioration in disease severity in patients who responded to surgery. Conclusions. Overall, findings from this study corroborate the results of previous reports showing that outcome of SCG DBS may be replicated across centers. (DOI: 10.3171/2011.10.JNS102122)
引用
收藏
页码:315 / 322
页数:8
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