Subcallosal Cingulate Cortex Deep Brain Stimulation for the Treatment of Refractory Mood Disorders: Evidence and Challenges

Chapter

Abstract

Although deep brain stimulation (DBS) is an accepted therapeutic strategy for the treatment of a number of neurological disorders, the use of DBS for treatment of psychiatric conditions, including treatment-resistant depression (TRD), is a nascent area of investigation. Guided by advances in neurocircuitry models of major depressive disorder, the subcallosal cingulate cortex (SCC) has emerged as one of the putative neuroanatomical targets for stimulation in patients with TRD. Since the first publication of the antidepressant effects of SCC DBS for the treatment of TRD in 2005, several case series have been published. The data from these open-label studies suggest that SCC DBS is associated with robust and sustained antidepressant responses and improved quality of life in patients with TRD and bipolar depression. To optimize patient outcomes, future challenges include understanding the neurophysiological and psychological adaptations that occur with continuous chronic stimulation of the SCC and the development of preoperative predictors of antidepressant response to SCC DBS.

Keywords

Depressive Symptom Suicidal Ideation Diffusion Tensor Imaging Deep Brain Stimulation Antidepressant Effect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Psychiatry, University Health Network – Toronto General HospitalUniversity of TorontoTorontoCanada
  2. 2.Division of Neurosurgery, Department of SurgeryUniversity of TorontoTorontoCanada
  3. 3.Division of Neurosurgery, University Health Network – Toronto Western HospitalUniversity of TorontoTorontoCanada

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