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Review
. 2022 Jul;19(4):1229-1245.
doi: 10.1007/s13311-022-01270-3. Epub 2022 Jul 11.

Deep Brain Stimulation for Depression

Martijn Figee  1 , Patricio Riva-Posse  2 , Ki Sueng Choi  3 , Lucia Bederson  3 , Helen S Mayberg  3 , Brian H Kopell  3
Affiliations
Review

Deep Brain Stimulation for Depression

Martijn Figee et al. Neurotherapeutics. 2022 Jul.

Abstract

Deep brain stimulation has been extensively studied as a therapeutic option for treatment-resistant depression (TRD). DBS across different targets is associated with on average 60% response rates in previously refractory chronically depressed patients. However, response rates vary greatly between patients and between studies and often require extensive trial-and-error optimizations of stimulation parameters. Emerging evidence from tractography imaging suggests that targeting combinations of white matter tracts, rather than specific grey matter regions, is necessary for meaningful antidepressant response to DBS. In this article, we review efficacy of various DBS targets for TRD, which networks are involved in their therapeutic effects, and how we can use this information to improve targeting and programing of DBS for individual patients. We will also highlight how to integrate these DBS network findings into developing adaptive stimulation and optimal trial designs.

Keywords: Deep brain stimulation; Depression; Neuromodulation; Neurostimulation; Treatment-resistant depression.

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Figures

Fig. 1
Fig. 1
Location of all antidepressant DBS targets
Fig. 2
Fig. 2
SCC stimulation location (left panel) and tractography of connections from the target (right panel)
Fig. 3
Fig. 3
LHb stimulation location (no tractography showed due to unclear pathway activation)
Fig. 4
Fig. 4
VC/VS stimulation location (left panel) and tractography of connections from the target (right panel)
Fig. 5
Fig. 5
MFB stimulation location (left panel) and tractography of connections from the target (right panel)
Fig. 6
Fig. 6
ITP stimulation location (left panel) and tractography of connections from the target (right panel)
See this image and copyright information in PMC

References

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