Journal
JOURNAL OF NEUROSURGERY
Volume 116, Issue 2, Pages 315-322Publisher
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/2011.10.JNS102122
Keywords
deep brain stimulation; depression; mood disorder; psychiatry; cingulate gyrus; subgenual cingulate
Categories
Funding
- Canadian Academy of Geriatric Psychiatry
- CIHR
- Department of Psychiatry-University Health Network
- Eli Lilly Canada Inc.
- Michael J. Fox Foundation for Parkinson's Research
- St. Jude Medical
- NARSAD
- AstraZeneca
- Biovail
- Eli Lilly
- GlaxoSmithKline
- Janssen-Ortho
- Lundbeck
- Pfizer
- Servier
- University of British Columbia) from Advanced Neuromodulation Systems Inc.
- BrainCells Inc.
- Canadian Institutes of Health Research
- Canadian Psychiatric Research Foundation
- Litebook Company Ltd.
- Mathematics of Information Technology and Advanced Computing Systems
- Michael Smith Foundation for Health Research
- UBC Institute of Mental Health/Coast Capital Savings
- Advanced Neuromodulation Systems Inc./St. Jude Medical
- B. C. Health Research Foundation
- Cyberonics Inc.
- Medical Research Council of Canada
- Medtronic of Canada Ltd.
- QLT Photo Therapeutics Inc.
- Titan Pharmaceuticals
- Vancouver Coastal Health Authority
- Vancouver General Hospital/University of B.C. Hospital Foundation
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Object. Deep brain stimulation (DBS) has been recently investigated as a treatment for major depression. One of the proposed targets for this application is the subcallosal cingulate gyms (SCG). To date, promising results after SCG DBS have been reported by a single center. In the present study the authors investigated whether these findings may be replicated at different institutions. They conducted a 3-center prospective open-label trial of SCG DBS for 12 months in patients with treatment-resistant depression. Methods. Twenty-one patients underwent implantation of bilateral SCG electrodes. The authors examined the reduction in Hamilton Rating Scale for Depression (HRSD-17) score from baseline (RESP50). Results. Patients treated with SCG DBS had an RESP50 of 57% at 1 month, 48% at 6 months, and 29% at 12 months. The response rate after 12 months of DBS, however, increased to 62% when defined as a reduction in the baseline HRSD-17 of 40% or more. Reductions in depressive symptomatology were associated with amelioration in disease severity in patients who responded to surgery. Conclusions. Overall, findings from this study corroborate the results of previous reports showing that outcome of SCG DBS may be replicated across centers. (DOI: 10.3171/2011.10.JNS102122)
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