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Related Experiment Videos

Deep brain stimulation for treatment-resistant depression.

Helen S Mayberg1, Andres M Lozano, Valerie Voon

  • 1Rotman Research Institute at Baycrest Centre, and Departments of Psychiatry and Neurology, University of Toronto, Toronto, Ontario, M6A 2E1, Canada. hmayber@emory.edu

Neuron
|March 8, 2005
PubMed
Summary
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Deep brain stimulation targeting the subgenual cingulate (Brodmann area 25) shows promise for treatment-resistant depression. Modulating this brain region reduced activity and led to sustained remission in most patients studied.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Devices

Background:

  • Treatment-resistant depression (TRD) is a severe condition with limited therapeutic options.
  • The subgenual cingulate region (Brodmann area 25) exhibits hyperactivity in TRD patients.
  • Previous research indicated potential for neuromodulation in psychiatric disorders.

Purpose of the Study:

  • To investigate the efficacy of chronic deep brain stimulation (DBS) targeting Brodmann area 25 (BA25) in patients with refractory depression.
  • To assess the impact of DBS on metabolic activity in the subgenual cingulate and associated brain networks.
  • To evaluate clinical outcomes and remission rates in patients undergoing DBS for TRD.

Main Methods:

  • Six patients with treatment-resistant depression received chronic deep brain stimulation.

Related Experiment Videos

  • Stimulation targeted white matter tracts adjacent to the subgenual cingulate gyrus (BA25).
  • Positron emission tomography (PET) was used to measure changes in cerebral blood flow and limbic-cortical activity.

    • Main Results:

    • Four out of six patients achieved sustained remission of depression symptoms.
    • Antidepressant effects correlated with reduced local cerebral blood flow in BA25.
    • PET scans revealed downstream changes in limbic and cortical sites following stimulation.

    Conclusions:

    • Chronic deep brain stimulation of the subgenual cingulate white matter can effectively reverse symptoms in treatment-resistant depression.
    • Modulating pathological activity in limbic-cortical circuits via DBS offers a potential therapeutic strategy.
    • This approach disrupts focal hyperactivity, leading to significant clinical benefit.