Why is deep brain stimulation for treatment-resistant depression a needed treatment option?

Riva‐Posse, Patricio

doi:10.1590/1516-4446-2020-0004

Cited by 5 publications

(4 citation statements)

References 34 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Electroconvulsive therapy is the first type of electrical stimulation therapy in TRD and has been shown to have a 50%-60% rate of efficacy. It is very effective in depression, with remission rates of 60%-90% reported in clinical trials, but relapse rates are high (almost 10%-50% relapse), and long courses of ECT have cumulative cognitive side effects that many times become intolerable for patients [16]. Electroconvulsive therapy is mainly considered for the treatment of severe depression, in the context of unipolar or bipolar disorders.…”

Section: Electroconvulsive Therapy (Ect)mentioning

confidence: 99%

“…The main disadvantages of VNS therapy can be as: i) Antidepressant effects of VNS in short-term (10-12 weeks) sham study demonstrated to be statistically nonsignificant, albeit, open-label long-term response and remission rates were high (27% response rate and 16% remission rate after 12 months of stimulation) and statistically significant [46], the average response time in VNS is 9 months after stimulation onset [47]; ii) In the longer-term study, 21%-50% of responders to VNS failed to maintain at least a 40% reduction in baseline depression severity over 1-2 years [39]; iii) VNS has no acute efficacy in the treatment of TRD but has shown to be effective in the treatment of chronic depression [48,49]; iv) Its high cost, lack of Medicare or Commercial coverage, and inadequacy in treating acute depression caused the number of patients benefitting from this treatment modality is low despite 15 years of commercial availability [16]; v) Although most of the VNS side effects are generally reversible, the most frequent acute complications include temporary salivation, coughing, paralysis of the vocal cords, lower facial weakness, rarely bradycardia, and, very rarely, asystole.…”

Section: Repetitive Transcranial Magnetic Stimulation (Rtms)mentioning

confidence: 99%

See 1 more Smart Citation

Can Deep Brain Stimulation Be a Promising Treatment for Treatment-Resistant Depression?

Nazanin¹,

Ijeuma²

2023

Int J Depress Anxiety

View full text Add to dashboard Cite

Background: In recent decades, despite remarkable advances in antidepressant medication, psychotherapy, and electrical stimulation, between 20%-30% of patients suffering from major depressive disorder remain untreated or are at a high risk of relapse. Deep brain stimulation (DBS) is a recently invented modality that has been under investigation since 2005, however, the US Food and Drug Administration (FDA) has not yet approved it as a final line in treating severe depression. Methods:In this study the author tried by reviewing the evidence-based articles on applying DBS for treating human depression, to reach a conclusion whether DBS has the potential to be the ultimate treatment for depressive disorder. Data were derived from evidence-based studies published on PubMed/Medline, the Cochrane Central Register of Controlled Trials, ScienceDirect, EMBASE, and APA PsycINFO. The emphasis was on applying DBS for human depression, consequently after refining inclusion and exclusion criteria, 42 articles that contain the results of 446 tested patients were reviewed. Conclusion:Data reanalysis demonstrated, DBS has the capability for treating severe measure depressive disorder (MDD) or refractory depression as an adjunctive treatment if its weaknesses including, the lack of consensus on DBS protocol and its stimulation parameters, duration of treatment, the effect of placebo, and considering the individualized pattern of depression become resolved through doing further highly controlled studies that compare the short-term and long-term effects.

show abstract

Section: Electroconvulsive Therapy (Ect)mentioning

confidence: 99%

Section: Repetitive Transcranial Magnetic Stimulation (Rtms)mentioning

confidence: 99%

Can Deep Brain Stimulation Be a Promising Treatment for Treatment-Resistant Depression?

Nazanin¹,

Ijeuma²

2023

Int J Depress Anxiety

View full text Add to dashboard Cite

show abstract

“…Recently, the FDA granted a breakthrough device designation permitting expedited review of Abbott's DBS System for TR‐MDD. Although no DBS therapy is currently FDA‐approved for this diagnostic indication, one clinical trial demonstrated good long‐term outcomes in response to DBS of subcallosal cingulate gyrus (SCG; Crowell et al, 2019; Posse, 2022). In a meta‐analysis of DBS interventions for TR‐MDD, the treatment group had a significantly higher response rate (OR = 5.50; 95% CI = 2.79, 10.85; p < 0.0001) and reductions in mean depression score (standardized mean difference, SMD = −0.42; 95% CI = −0.72, −0.12; p = 0.006) than the sham controls group.…”

Section: Studies Supporting Current Targets Of Deep Brain Stimulationmentioning

confidence: 99%

A perspective on translating genomic discoveries into targets for brain‐machine interface and deep brain stimulation devices

Valentim,

Tylee,

Polimanti

2023

WIREs Mechanisms of Disease

View full text Add to dashboard Cite

Mental illnesses have a huge impact on individuals, families, and society, so there is a growing need for more efficient treatments. In this context, brain‐computer interface (BCI) technology has the potential to revolutionize the options for neuropsychiatric therapies. However, the development of BCI‐based therapies faces enormous challenges, such as power dissipation constraints, lack of credible feedback mechanisms, uncertainty of which brain areas and frequencies to target, and even which patients to treat. Some of these setbacks are due to the large gap in our understanding of brain function. In recent years, large‐scale genomic analyses uncovered an unprecedented amount of information regarding the biology of the altered brain function observed across the psychopathology spectrum. We believe findings from genetic studies can be useful to refine BCI technology to develop novel treatment options for mental illnesses. Here, we assess the latest advancements in both fields, the possibilities that can be generated from their intersection, and the challenges that these research areas will need to address to ensure that translational efforts can lead to effective and reliable interventions. Specifically, starting from highlighting the overlap between mechanisms uncovered by large‐scale genetic studies and the current targets of deep brain stimulation treatments, we describe the steps that could help to translate genomic discoveries into BCI targets. Because these two research areas have not been previously presented together, the present article can provide a novel perspective for scientists with different research backgrounds.This article is categorized under: Neurological Diseases > Genetics/Genomics/Epigenetics Neurological Diseases > Biomedical Engineering

show abstract

“… 3 , 4 While pharmacotherapy and psychotherapy are effective in reducing depressive symptoms, 5 , 6 a considerable number of patients (about 30%) do not achieve remission even after multiple trials. 7 - 9 Although there is no consensus regarding the concept of treatment-resistant depression (TRD), it is usually defined as the lack of clinical response to at least two antidepressant trials employed in adequate doses and periods. 10 - 15 For these patients, neurostimulation therapies (NTs) may be required to manage their symptoms.…”

Section: Introductionmentioning

confidence: 99%

A narrative review on invasive brain stimulation for treatment-resistant depression

Dandekar

Diaz

Rahman

et al. 2022

Braz. J. Psychiatry

Self Cite

View full text Add to dashboard Cite

While most patients with depression respond to pharmacotherapy and psychotherapy, about one-third will present treatment resistance to these interventions. For patients with treatment-resistant depression (TRD), invasive neurostimulation therapies such as vagus nerve stimulation, deep brain stimulation, and epidural cortical stimulation may be considered. We performed a narrative review of the published literature to identify papers discussing clinical studies with invasive neurostimulation therapies for TRD. After a database search and title and abstract screening, relevant English-language articles were analyzed. Vagus nerve stimulation, approved by the U.S. Food and Drug Administration as a TRD treatment, may take several months to show therapeutic benefits, and the average response rate varies from 15.2-83%. Deep brain stimulation studies have shown encouraging results, including rapid response rates (> 30%), despite conflicting findings from randomized controlled trials. Several brain regions, such as the subcallosal-cingulate gyrus, nucleus accumbens, ventral capsule/ventral striatum, anterior limb of the internal capsule, medial-forebrain bundle, lateral habenula, inferior-thalamic peduncle, and the bed-nucleus of the stria terminalis have been identified as key targets for TRD management. Epidural cortical stimulation, an invasive intervention with few reported cases, showed positive results (40-60% response), although more extensive trials are needed to confirm its potential in patients with TRD.

show abstract

Why is deep brain stimulation for treatment-resistant depression a needed treatment option?

Cited by 5 publications

References 34 publications

Can Deep Brain Stimulation Be a Promising Treatment for Treatment-Resistant Depression?

Can Deep Brain Stimulation Be a Promising Treatment for Treatment-Resistant Depression?

A perspective on translating genomic discoveries into targets for brain‐machine interface and deep brain stimulation devices

A narrative review on invasive brain stimulation for treatment-resistant depression

Contact Info

Product

Resources

About