Deep Brain Stimulation for Depression
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Open-label studies of deep brain stimulation (DBS) for patients with treatment-resistant depression (TRD) are promising: approximately 40% of patients lose at least half of their symptoms following DBS of the subcallosal cingulate cortex (SCC) or ventral capsule and ventral striatum (VC/VS). The results of sham-controlled trials, however, have been mixed so far and show much room for optimization. For instance, targeting specific white matter bundles shows a lot of potential, with at least 70% of patients responding to targeting of patient-specific SCC bundles or the medial forebrain bundle. Exploring the additional value of rehabilitation and cognitive behavioral programs, as well as optimizing parameter selection, could further optimize the treatment.
KeywordsDeep brain stimulation DBS Treatment refractory depression TRD Efficacy Safety Mechanisms
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