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Cited by 75Deep Brain Stimulation and Movement DisordersTreatment of Major DepressionTranscranial Magnetic Stimulation Studies

The DOI matches its Crossref record; 76 of the 76 references it cites were found in a registry or an index.

Neurobiological Background for Performing Surgical Intervention in the Inferior Thalamic Peduncle for Treatment of Major Depression Disorders

Velasco, Francisco, Velasco, Marcos, Jiménez, Fiacro, Velasco, Ana Luisa, Salin-Pascual, Rafael·2005·Neurosurgery
DOI 10.1227/01.neu.0000172172.51818.51
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Abstract

OBJECTIVE: To present a review of evidence for an inhibitory thalamo-orbitofrontal system related to physiopathology of major depression disorders (MDDs) and to postulate that interfering with hyperactivity of the thalamo-orbitofrontal system by means of chronic high-frequency electrical stimulation of its main fiber connection, the inferior thalamic peduncle (ITP), may result in an improvement in patients with MDD. METHODS: Experimentally, the thalamo-orbitofrontal system has been proposed as part of the nonspecific thalamic system. Under normal conditions, the nonspecific thalamic system induces characteristic electrocortical synchronization in the form of recruiting responses that mimic some sleep stages. It also inhibits input of irrelevant sensory stimuli, thus facilitating the process of selective attention. Permanent disruption of the system, via lesioning or temporary inactivation through cooling of the ITP with cryoprobes, results in a state of hyperkinesia, increased attention, and cortical desynchronization. RESULTS: Surgical lesioning of the medial part of orbitofrontal cortex and white matter overlying area 13, which includes the ITP, may result in significant improvement in MDD. Imaging studies (functional magnetic resonance imaging and positron emission tomography) consistently demonstrate hyperactivity in the orbitofrontal cortex and midline thalamic regions during episodes of MDD. This hyperactivity decreases with efficient control of MDD by medical treatment, indicating that orbitofrontal cortex and midline thalamic overactivity are related to the depressive condition. Conversely, noradrenergic and serotoninergic systems in the frontal lobes have been implicated in the pathophysiology of MDD. Although noradrenergic receptor density in the frontal lobe is consistently increased in depressed patients who commit suicide, 5-hydroxytryptamine reuptake blockers, which are potent antidepressive drugs, decrease hypermetabolism in the orbital frontal cortex in MDD. Therefore, the serotonin hypothesis for depression postulates that norepinephrine and serotonin in the frontal lobes are required to maintain antidepressive responsiveness. Dysregulation of the secretion of both neurotransmitters initiates overactivity of orbitofrontal cortex, resulting in depression. It is possible that surgical interventions in this region, including electrical stimulation of ITP, disrupt adrenergic and serotoninergic dysregulation in patients with MDD. CONCLUSION: Circumscribed lesions or electrical stimulation of the ITP, a discrete target easily identified by electrophysiological studies, may improve MDD. Electrical stimulation may have the advantage of being less invasive and more adjustable to patient needs.

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  • The inferior thalamic peduncle connects the dorsomedial thalamus with the orbitofrontal cortex, and both regions show hypermetabolism in depressed patients.

    “The inferior thalamic peduncle (ITP) connects the dorsomedial thalamus with the orbitofrontal cortex, which both show hypermetabolism in depressed patients [73].”

    From Deep brain stimulation for depression. (2022) · cites this paper as [73]

Citations

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Research works printed but not linked: 18

  1. Akimoto, 1956, On sleep induced through electrical stimulation of dog thalamus, Folia Psychiat Neurol Jap, 10, 117
  2. Cummings, 1993, The neuroanatomy of depression, J Clin Psychiatry, 54, 14
  3. Drevets, 1999, Neuroimaging studies of depression, 394
  4. Fulton, 1935, The functions of the frontal lobes: A comparative study in monkeys, chimpanzees and man, Adv Mod Biol (Moscow), 4, 113
  5. Hess, 1944, Das schlafsyndrom als folge dienzephaler reizung, Helv Physiol Pharmacol Acta, 2, 304
  6. Kegeles, 1999, Response of cortical metabolic deficits to serotonergic challenges in mood disorders, Biol Psychiatry, 45, 765
  7. Leksell, 1979, Stereotactic gamma capsulotomy, 213
  8. Lindsley, 1960, Attention, consciousness, sleep and wakefulness, 1553
  9. Lorente de Nó, 1943, Cerebral cortex, intracortical connections, motor projections, 75
  10. Maes, 1995, The serotonin hypothesis of major depression, 933
  11. Magoun, 1963, The Walking Brain, 174
  12. Marek, 2002, Neural circuitry and signaling in depression, 153
  13. Meyerson, 1994, Neurosurgical treatment of mental disorders: Introduction and indications, 1955
  14. Plofaky, 1995, Neuropeptide alteration in mood disorders, 971
  15. Velasco, 1968, Nuevos conceptos sobre el centroencefalo: Un sistema tálamo-orbitofrontal inhibitorio, Neurol Neurosci Psiquiat (Méx), 9, 71
  16. Velasco M. Skinner, 1976, Thalamocortical systems regulating spindle bursts and recruiting responses: III—Blockade of the thalamo-orbital system by lesions in the forebrain and rostral diencephalon, Acta Neurol Latinoamer, 22, 1
  17. Velasco, 1969, Effect of orbitofrontal lesions on thalamically induced recruiting responses and arrest reaction, Fed Proc, 28, 455
  18. Velasco, 1966, Role of the orbitofrontal cortex on thalamocortical potentials and behavior, Neurology (Minn), 16, 327

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Metadata

Authors
Velasco, F., Velasco, M., Jiménez, F., Velasco, A. L., & Salin-Pascual, R.
Affiliations
  • Hospital General de México (MX)
  • Mexican Social Security Institute (MX)
  • Psychiatry Department, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
ORCID
Venue
Neurosurgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-09-01
Volume
57
Issue
3
Pages
439-448
ISSN
  • 0148-396X (ISSN-L)
  • 1524-4040
DOI
10.1227/01.neu.0000172172.51818.51
OpenAlex
W2037706376
Cited by
75
References
76
Citations by year
2026: 1 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 7 · 2012: 7
FWCI
0.86
Type
journal article
Language
en
Open access
closed
Locations
  • Neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
major depressive disorder, deep brain stimulation, frontal lobe, cortical desynchronization
MeSH terms
Animals, Major Depressive Disorder, Humans, Magnetic Resonance Imaging, Models, Neurological, Neural Pathways, Neurobiology, Thalamus, Neurotransmitter Agents, Neurosurgical Procedures

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