Long-Term Outcomes of Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Depression.

Area of Science:

• Neuroscience
• Psychiatry
• Neurosurgery

Background:

• Major depressive disorder (MDD) is a leading cause of disability worldwide.
• Severe and refractory MDD often requires novel therapeutic approaches.
• Deep brain stimulation (DBS) targets specific brain regions for neuromodulation.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of subcallosal cingulate (SCC) DBS for treatment-resistant depression.
• To assess sustained response and remission rates in patients undergoing SCC DBS.
• To analyze long-term outcomes over 4-8 years of follow-up.

Main Methods:

• Open-label, long-term follow-up study design.
• Inclusion of 28 patients with major depressive disorder or bipolar II disorder receiving SCC DBS.
• Data collection on response, remission, and adverse events over 4-8 years.

Main Results:

• Sustained response and remission rates of ≥50% and ≥30% respectively, maintained from year 2 to year 8.
• 75% of participants achieved treatment response for over half their study duration.
• SCC DBS was generally safe and well-tolerated, with no reported suicides or stimulation-related side effects.

Conclusions:

• Subcallosal cingulate deep brain stimulation demonstrates robust and sustained antidepressant effects in patients with severe, treatment-resistant depression.
• Long-term follow-up confirms the enduring efficacy of SCC DBS.
• The procedure is associated with a favorable safety profile for long-term use.