Cited by 897Deep Brain Stimulation and Movement DisordersObsessive-Compulsive Spectrum DisordersTreatment of Major Depression

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Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Treatment-Resistant Depression

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Malone, Donald A., Dougherty, Darin D., Rezai, Ali R., Carpenter, Linda L., Friehs, Gerhard M., Eskandar, Emad N., Rauch, Scott L., Rasmussen, Steven A., Machado, Andre G., Kubu, Cynthia S., Tyrka, Audrey R., Price, Lawrence H., Stypulkowski, Paul H., Giftakis, Jonathon E., Rise, Mark T., Malloy, Paul F., Salloway, Stephen P., Greenberg, Benjamin D.·2009·Biological Psychiatry

DOI 10.1016/j.biopsych.2008.08.029PMC PMC3486635

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Abstract

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.

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Authors: Malone, D. A., Dougherty, D. D., Rezai, A. R., Carpenter, L. L., Friehs, G. M., Eskandar, E. N., Rauch, S. L., Rasmussen, S. A., Machado, A. G., Kubu, C. S., Tyrka, A. R., Price, L. H., Stypulkowski, P. H., Giftakis, J. E., Rise, M. T., Malloy, P. F., Salloway, S. P., & Greenberg, B. D.
Affiliations: Cleveland Clinic (US)
McLean Hospital (US)
Butler Hospital (US)
Brown University (US)
Massachusetts General Hospital (US)
Medtronic (United States) (US)
Corresponding author: Malone, Donald A.
ORCID: Dougherty, Darin D.
Rezai, Ali R.
Carpenter, Linda L.
Eskandar, Emad N.
Rauch, Scott L.
Rasmussen, Steven A.
Kubu, Cynthia S.
Tyrka, Audrey R.
Price, Lawrence H.
Giftakis, Jonathon E.
Salloway, Stephen P.
Greenberg, Benjamin D.
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2009-02
Volume: 65
Issue: 4
Pages: 267-275
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2008.08.029
PMC: PMC3486635
OpenAlex: W2014786844
Cited by: 897
References: 39
Citations by year: 2026: 16 · 2025: 20 · 2024: 41 · 2023: 46 · 2022: 37 · 2021: 38 · 2020: 34 · 2019: 51 · 2018: 45 · 2017: 57 · 2016: 58 · 2015: 70 · 2014: 70 · 2013: 64 · 2012: 81
FWCI: 35.18
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5p50mh086400-05)
National Institute of Mental Health (P-50-MH-086400)
National Eye Institute (R01EY017658)
Topics: Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords: deep brain stimulation, ventral capsule/ventral striatum, treatment-resistant depression, depression remission, long-term outcomes
MeSH terms: Adolescent, Adult, Chronic Disease, Cognition, Depressive Disorder, Drug Resistance, Electrodes, Implanted, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Recurrence, Treatment Outcome, Neostriatum, Deep Brain Stimulation, Young Adult

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Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Treatment-Resistant Depression

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