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Cited by 16Neurological disorders and treatmentsObsessive-Compulsive Spectrum DisordersTreatment of Major Depression

Long-term results of deep brain stimulation for treatment-resistant depression: outcome analysis and correlation with lead position and electrical parameters

Aibar-Durán, Juan Ángel, Rodríguez Rodríguez, Rodrigo, de Diego Adeliño, Francisco Javier, Portella, María J., Álvarez-Holzapfel, María Jesús, Martín Blanco, Ana, Puigdemont Campos, Dolors, Molet Teixidó, Joan·2022·Neurosurgery
DOI 10.1227/neu.0000000000001739
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Abstract

BACKGROUND: Long-term efficacy and mechanisms of action of deep brain stimulation (DBS) for treatment-resistant depression (TRD) are under investigation. OBJECTIVE: To compare long-term outcomes with active electrode's coordinates and its electrical parameters in patients with TRD treated with DBS in the subgenual cingulate gyrus (SCG-DBS). METHODS: Seventeen patients with TRD underwent SCG-DBS. Demographic and baseline characteristics were recorded. The 17-item Hamilton Depression Rating Scale was used to measure the response to the therapy. The anterior commissure-posterior commissure coordinates of the active contacts and the total electrical energy delivered were calculated and correlated with clinical outcomes. Patient-specific tractographic analysis was performed to identify the modulated pathways in responders. RESULTS: Twelve women (70.6%) and 5 men (29.4%) with a median age of 48 yr (34-70 years) were included. Along the 5-year follow-up, 3 main clinical trajectories were observed according to symptom's improvement: great responders (≥80%), medium responders (≥50%-79%), and poor responders (<50%). Active contacts' coordinates and total electrical energy delivered showed no correlation with clinical outcomes. Brodmann area 10 medial was the most frequently stimulated area and the forceps minor, the most frequently modulated tract. CONCLUSION: SCG-DBS for TRD is clearly effective in some patients. Active contacts' coordinates were highly variable within the region and, like electrical parameters, did not seem to correlate with clinical outcomes. In the current series, Brodmann area 10 medial and the forceps minor were the most frequently targeted area and modulated pathway, respectively.

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Crossref · 10.1227/neu.0000000000001739

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  • Another retrospective study of 17 treatment-resistant depression patients found activation of the forceps minor and uncinate fascicle but not cingulate bundle and no association between activated bundles and response, but this study did not apply tractography-based targeting.

    “Another retrospective study of 17 TRD patients (RS: 58.9%, RM: 35.5%) found activation of the forceps minor and uncinate fascicle but not cingulate bundle and no association between activated bundles and response but this study did not apply tractography-based targeting [31].”

    From Deep brain stimulation for depression. (2022) · cites this paper as [31]

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Authors
Aibar-Durán, J. Á., Rodríguez Rodríguez, R., de Diego Adeliño, F. J., Portella, M. J., Álvarez-Holzapfel, M. J., Martín Blanco, A., Puigdemont Campos, D., & Molet Teixidó, J.
Affiliations
  • Department of Neurosurgery, Santa Creu i Sant Pau Hospital, Barcelona, Spain;
  • Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
  • Hospital de Sant Pau (ES)
Corresponding author
Álvarez-Holzapfel, María Jesús
Venue
Neurosurgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-11-29
Volume
90
Issue
1
Pages
72-80
ISSN
  • 0148-396X (ISSN-L)
  • 1524-4040
DOI
10.1227/neu.0000000000001739
OpenAlex
W4200020782
Cited by
16
References
39
Citations by year
2026: 1 · 2025: 3 · 2024: 6 · 2023: 4 · 2022: 2
FWCI
1.43
Type
journal article
Language
en
Open access
closed
Locations
  • Neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Neurological disorders and treatments
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
deep brain stimulation, treatment-resistant depression, electrical stimulation parameters, tractography, forceps minor, long-term treatment outcomes
MeSH terms
Adult, Aged, Corpus Callosum, Depression, Female, Gyrus Cinguli, Humans, Male, Middle Aged, Treatment Outcome, Deep Brain Stimulation, Depressive Disorder, Treatment-Resistant

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