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Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Treatment-Resistant Depression
Open accessAbstract
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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“deep brain stimulation applied via electrodes situated in the accumbens area/ventral internal capsule improves depressive symptoms in treatmentrefractory depression (Malone et al, 2009;Schlaepfer et al, 2008).”
From Neurocircuitry of Mood Disorders (2010) · cites this paper as Malone et al, 2009
In the citing paper
“DBS for MDD targets the cingulate cortex or the striatum, which includes the NAc, and has been shown to enhance activity in these regions and connected areas involved in anhedonia and motivation [145, 146], as well as activity in the PFC and amygdala [139].”
From Beyond the serotonin deficit hypothesis: Communicating a neuroplasticity framework of major depressive disorder (2024) · cites this paper as [145]
In the citing paper
“In a multi-center study, Malone and colleagues demonstrated antidepressant effects in 15 patients at a minimum of 6-month follow-up (RS: 53.3%, RM: 40%) [57].”
From Deep brain stimulation for depression. (2022) · cites this paper as [57]
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“| | Malone et al | 2009 Open label | N = 15 | 6 | 53.3% | 40.0% | HDRS |”
From Deep brain stimulation for depression. (2022) · cites this paper as [57]
In the citing paper
“| | Malone et al | 2009 Open label | N = 15 | 6 | 53.3% | 40.0% | HDRS |”
From Deep brain stimulation for depression. (2022) · cites this paper as [57]
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Metadata
- 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
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-02
- Volume
- 65
- Issue
- 4
- Pages
- 267-275
- ISSN
- 0006-3223 (ISSN-L)
- 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
- 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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