Deep brain stimulation of the medial forebrain bundle: Distinctive responses in resistant depression

Fenoy, Albert J.; Schulz, Paul E.; Selvaraj, Sudhakar; Burrows, Christina L.; Spiker, Danielle; Cao, Bo; Zunta-Soares, Giovanna; Gajwani, Prashant; Quevedo, Joao L De; Soares, Jair C.

doi:10.1016/j.jad.2016.05.064

Cited by 102 publications

(100 citation statements)

References 37 publications

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“…The present case-report supports the available, growing evidence about the efficacy and tolerability of slMFB-DBS for patients with TRD and TR-OCD [12,13]. This target was already found to determine a rapid clinical improvement [11], as observed in our patient, who also showed a sustained remission at 12 months.…”

Section: Discussionsupporting

confidence: 88%

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Deep Brain Stimulation of the Medial Forebrain Bundle in a Patient with Treatment-Resistant Bipolar Depression and Comorbid OCD: Acute and 12-Month Follow-Up Results

Oldani¹,

Porta²,

Servello³

et al. 2017

Neuropsychiatry

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Limited but encouraging evidence exists on the efficacy of Deep Brain Stimulation (DBS) of the Medial Forebrain Bundle (MBF) in otherwise intractable patients with Major Depressive and Obsessive-Compulsive Disorder (OCD). Subject and Methods: Herein, we present acute and follow-up results (up to 12-months) of the first Italian patient, a 34 year old man with a diagnosis of treatment-resistant Bipolar Depression (BD) and comorbid OCD, successfully treated with DBS of the MFB. Periodic follow-up visits with psychometric evaluations highlighted a remarkable improvement of patient's depressive and OC symptoms at 3 months (50-80% scores reduction), that was maintained at 6 and 12 months. In particular, suicidal ideation, which was found to be pervasive before the implant as well as patient's overall disability, showed a rapid and significant acute response to DBS. Over the 12 months of stimulation, pre-implant pharmacological treatment could be gradually decreased, while the patient remained clinically stable. According to the limited, reported experience, we support the efficacy and tolerability of DBS of the MFB as a promising intervention in patients with treatment-resistant BD and comorbid OCD, particularly in relation to acute and post-acute outcome. Larger controlled trials are needed to confirm our findings and assess DBS therapeutic properties in the long-term.

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Section: Discussionsupporting

confidence: 88%

“…Such structures play a crucial role in regulating the reward pathways and have been reportedly indicated as effective DBS targets in patients with TRD [11][12][13]. Few follow-up studies exist on the DBS-implanted patients, particularly with respect to the MFB target.…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation of the Medial Forebrain Bundle in a Patient with Treatment-Resistant Bipolar Depression and Comorbid OCD: Acute and 12-Month Follow-Up Results

Oldani¹,

Porta²,

Servello³

et al. 2017

Neuropsychiatry

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“…Ten publications from nine studies met inclusion criteria (Bergfeld et al., ; Dougherty et al., ; Kubu et al., ; Merkl et al., ; Holtzheimer et al., , ; Puigdemont et al., ; Ramasubbu, Anderson, Haffenden, Chavda, & Kiss, ; Schlaepfer, Bewernick, Braeuer, & Coenen, ; Fenoy et al., ). Table gives details of those studies that were excluded at the full‐text level.…”

Section: Resultsmentioning

confidence: 99%

“…The last study was also single‐blinded. Patients were unaware that they were receiving sham treatment for 4 weeks after surgery before crossing over to active DBS (Fenoy et al., ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of deep brain stimulation for depression

et al. 2018

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“…Rapid antidepressant effects were observed in six out of seven TRD patients, and four patients were in full remission at last follow-up (between 12-33 weeks). In a recent interim analysis of an ongoing pilot study including 10 TRD patients, the results of four patients treated with DBS of the MFB were presented (Fenoy et al, 2016). During the sham phase, no significant changes in mood were observed.…”

Section: Mood Disordersmentioning

confidence: 99%

The application of deep brain stimulation in the treatment of psychiatric disorders

Graat

Figee

Denys

2017

International Review of Psychiatry

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Deep brain stimulation (DBS) is a last-resort treatment for neurological and psychiatric disorders that are refractory to standard treatment. Over the last decades, the progress of DBS in psychiatry has been slower than in neurology, in part owing to the heterogenic symptomatology and complex neuroanatomy of psychiatric disorders. However, for obsessive-compulsive disorder (OCD) DBS is now an accepted treatment. This study first reviews clinical outcomes and mechanisms of DBS for OCD, and then discusses these results in an overview of current and future psychiatric applications, including DBS for mood disorders, Tourette's syndrome, addiction, anorexia nervosa, autism, schizophrenia, and anxiety disorders. In addition, it will focus on novel techniques that may enhance the application of DBS in psychiatry.ARTICLE HISTORY

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Deep brain stimulation of the medial forebrain bundle: Distinctive responses in resistant depression

Cited by 102 publications

References 37 publications

Deep Brain Stimulation of the Medial Forebrain Bundle in a Patient with Treatment-Resistant Bipolar Depression and Comorbid OCD: Acute and 12-Month Follow-Up Results

Deep Brain Stimulation of the Medial Forebrain Bundle in a Patient with Treatment-Resistant Bipolar Depression and Comorbid OCD: Acute and 12-Month Follow-Up Results

A systematic review and meta-analysis of deep brain stimulation for depression

The application of deep brain stimulation in the treatment of psychiatric disorders

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