High-frequency measurement of depressive severity in a patient treated for severe treatment-resistant depression with deep-brain stimulation
Open accessAbstract
Although there have been previous studies of deep-brain stimulation (DBS), we present, to our knowledge, the first example of high-frequency depressive severity measurement-based DBS treatment in particular and psychiatric treatment in general. Daily post-surgical e-mail prompts for a period of 6 months resulted in 93 administrations of a computerized adaptive test (CAT) of depression severity (CAT-Depression Inventory or CAT-DI) via the internet. There was an average of 3.37 weekly measurements with an average separation of 2.12 days. No additional incentive was provided to the patient for completing the adaptive tests. The patient is a 55-year-old female with six psychiatric hospitalizations for depression, two suicide attempts, marginal response to eight electroconvulsive therapy (ECT) treatments and 35 psychotropic medications. We report results after high-frequency stimulation of the superolateral branch of the medial forebrain bundle. The CAT-DI was used for daily assessments before, during and after (remotely in response to an e-mail prompt) the DBS procedure. Two follow-up Hamilton Depression Scales (HAM-Ds) were also collected. Response to treatment varied markedly, with a decrease from severe (>75) to mild (60), which is three times the size of the uncertainty level. Although the HAM-D scores decreased, they missed the more complete temporal pattern identified by CAT-DI daily monitoring. We demonstrated feasibility of daily depressive severity measurement at high levels of precision and compliance. Clinician ratings confirm the general pattern of treatment benefit, but mask the marked variability in mood and more marked periods of benefit and decline.
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In a case study, the HDRS-measured effect of MFB DBS was masked by mood variability and by more marked periods of benefit and decline measured with CAT-DI.
“in a case study, the effect of MFB DBS measured with the HDRS was masked by the variability in mood and more marked periods of benefit and decline measured with a computerized adaptive test (CAT-DI)”
From Deep brain stimulation for depression. (2022) · cites this paper as [13]
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Deep brain stimulation for depression.
Figee, M., Riva-Posse, P., Choi, K. S., Bederson, L., Mayberg, H. S., & Kopell, B. H. (2022) · Neurotherapeutics · doi:10.1007/s13311-022-01270-3 · Cited by 175 · see citing works
- Authors
- Sani, S., Busnello, J., Kochanski, R., Cohen, Y., & Gibbons, R. D.
- Affiliations
- Rush University (US)
- University of Chicago (US)
- Corresponding author
- Gibbons, R D
- Venue
- Translational Psychiatry
- Published
- 2017-08-15
- Volume
- 7
- Issue
- 8
- Pages
- e1207-e1207
- ISSN
- 2158-3188 (ISSN-L)
- PMC
- PMC5611718
- OpenAlex
- W2750396313
- Cited by
- 14
- References
- 22
- Citations by year
- 2025: 2 · 2024: 3 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 1
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Translational Psychiatry (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH066302)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- deep brain stimulation, treatment-resistant depression, computerized adaptive testing, remote patient monitoring, medial forebrain bundle, treatment response variability, Hamilton Depression Rating Scale
- MeSH terms
- Female, Humans, Medial Forebrain Bundle, Middle Aged, Patient Compliance, Psychiatric Status Rating Scales, Severity of Illness Index, Treatment Outcome, Telemedicine, Deep Brain Stimulation, Depressive Disorder, Treatment-Resistant
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