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One year double blind study of high vs low frequency subcallosal cingulate stimulation for depression
Renana Eitan1, Denys Fontaine2, Michel Benoît3
1Department of Medical Neurobiology (Physiology), Institute of Medical Research - Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem, Israel; The Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Biological Psychiatry Laboratory, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Journal of Psychiatric Research
|October 17, 2017
Summary
High-frequency Subcallosal Brodmann
Area of Science:
- Neuroscience
- Psychiatry
- Neurosurgery
Background:
- Treatment-resistant major depressive disorder (TR-MDD) lacks optimal therapeutic strategies.
- Subcallosal Brodmann's Area 25 (Cg25) Deep Brain Stimulation (DBS) shows promise for TR-MDD.
- Optimal DBS stimulation parameters for depression are not established.
Purpose of the Study:
- To evaluate the efficacy of high (130 Hz) versus low (20 Hz) frequency Cg25 DBS in patients with TR-MDD.
- To compare the effects of different stimulation frequencies on depressive symptom scores.
- To investigate the long-term outcomes of Cg25 DBS for TR-MDD.
Main Methods:
- Prospective, multi-center, double-blind, randomized, crossover study.
- Nine patients with TR-MDD received Cg25 DBS for 13 months.
- Stimulation parameters compared: high frequency (130 Hz) vs. low frequency (20 Hz).
- Symptom severity assessed using MADRS scores.
Main Results:
- Four out of nine patients met response criteria (≥40% MADRS reduction).
- Similar symptom improvement observed in both high and low frequency groups after 6 months.
- Greater improvement in MADRS scores noted in the high-frequency group during the second stimulation period.
- Long-term high-frequency stimulation suggested potential for best outcomes.
Conclusions:
- Cg25 DBS is a potential therapy for TR-MDD.
- High-frequency stimulation may offer superior long-term benefits.
- Larger randomized trials are necessary to determine optimal stimulation parameters for Cg25 DBS in depression.