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Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features
Deep brain stimulation (DBS) of structures in the brain’s reward system is a promising therapeutic option for patients with treatment-resistant depression (TRD). Recently, DBS of the habenula (HB) in the brain’s anti-reward system has also been reported to alleviate depressive symptoms in patients w...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813927/ https://www.ncbi.nlm.nih.gov/pubmed/35115488 http://dx.doi.org/10.1038/s41398-022-01818-z |
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author | Zhang, Chencheng Zhang, Yingying Luo, Huichun Xu, Xinmeng Yuan, Ti-fei Li, Dianyou Cai, Yi-yun Gong, Hengfen Peng, Dai-hui Fang, Yi-ru Voon, Valerie Sun, Bomin |
author_facet | Zhang, Chencheng Zhang, Yingying Luo, Huichun Xu, Xinmeng Yuan, Ti-fei Li, Dianyou Cai, Yi-yun Gong, Hengfen Peng, Dai-hui Fang, Yi-ru Voon, Valerie Sun, Bomin |
author_sort | Zhang, Chencheng |
collection | PubMed |
description | Deep brain stimulation (DBS) of structures in the brain’s reward system is a promising therapeutic option for patients with treatment-resistant depression (TRD). Recently, DBS of the habenula (HB) in the brain’s anti-reward system has also been reported to alleviate depressive symptoms in patients with TRD or bipolar disorder (BD). In this pilot open-label prospective study, we explored the safety and clinical effectiveness of HB–DBS treatment in seven patients with TRD or BD. Also, local field potentials (LFPs) were recorded from the patients’ left and right HB to explore the power and asymmetry of oscillatory activities as putative biomarkers of the underlying disease state. At 1-month follow-up (FU), depression and anxiety symptoms were both reduced by 49% (n = 7) along with substantial improvements in patients’ health status, functional impairment, and quality of life. Although the dropout rate was high and large variability in clinical response existed, clinical improvements were generally maintained throughout the study [56%, 46%, and 64% reduction for depression and 61%, 48%, and 70% reduction for anxiety at 3-month FU (n = 5), 6-month FU (n = 5), and 12-month FU (n = 3), respectively]. After HB–DBS surgery, sustained improvements in mania symptoms were found in two patients who presented with mild hypomania at baseline. Another patient, however, experienced an acute manic episode 2 months after surgery that required hospitalization. Additionally, weaker and more symmetrical HB LFP oscillatory activities were associated with more severe depression and anxiety symptoms at baseline, in keeping with the hypothesis that HB dysfunction contributes to MDD pathophysiology. These preliminary findings indicate that HB–DBS may offer a valuable treatment option for depressive symptoms in patients who suffer from TRD or BD. Larger and well-controlled studies are warranted to examine the safety and efficacy of HB–DBS for treatment-refractory mood disorders in a more rigorous fashion. |
format | Online Article Text |
id | pubmed-8813927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-88139272022-02-10 Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features Zhang, Chencheng Zhang, Yingying Luo, Huichun Xu, Xinmeng Yuan, Ti-fei Li, Dianyou Cai, Yi-yun Gong, Hengfen Peng, Dai-hui Fang, Yi-ru Voon, Valerie Sun, Bomin Transl Psychiatry Article Deep brain stimulation (DBS) of structures in the brain’s reward system is a promising therapeutic option for patients with treatment-resistant depression (TRD). Recently, DBS of the habenula (HB) in the brain’s anti-reward system has also been reported to alleviate depressive symptoms in patients with TRD or bipolar disorder (BD). In this pilot open-label prospective study, we explored the safety and clinical effectiveness of HB–DBS treatment in seven patients with TRD or BD. Also, local field potentials (LFPs) were recorded from the patients’ left and right HB to explore the power and asymmetry of oscillatory activities as putative biomarkers of the underlying disease state. At 1-month follow-up (FU), depression and anxiety symptoms were both reduced by 49% (n = 7) along with substantial improvements in patients’ health status, functional impairment, and quality of life. Although the dropout rate was high and large variability in clinical response existed, clinical improvements were generally maintained throughout the study [56%, 46%, and 64% reduction for depression and 61%, 48%, and 70% reduction for anxiety at 3-month FU (n = 5), 6-month FU (n = 5), and 12-month FU (n = 3), respectively]. After HB–DBS surgery, sustained improvements in mania symptoms were found in two patients who presented with mild hypomania at baseline. Another patient, however, experienced an acute manic episode 2 months after surgery that required hospitalization. Additionally, weaker and more symmetrical HB LFP oscillatory activities were associated with more severe depression and anxiety symptoms at baseline, in keeping with the hypothesis that HB dysfunction contributes to MDD pathophysiology. These preliminary findings indicate that HB–DBS may offer a valuable treatment option for depressive symptoms in patients who suffer from TRD or BD. Larger and well-controlled studies are warranted to examine the safety and efficacy of HB–DBS for treatment-refractory mood disorders in a more rigorous fashion. Nature Publishing Group UK 2022-02-03 /pmc/articles/PMC8813927/ /pubmed/35115488 http://dx.doi.org/10.1038/s41398-022-01818-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Zhang, Chencheng Zhang, Yingying Luo, Huichun Xu, Xinmeng Yuan, Ti-fei Li, Dianyou Cai, Yi-yun Gong, Hengfen Peng, Dai-hui Fang, Yi-ru Voon, Valerie Sun, Bomin Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features |
title | Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features |
title_full | Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features |
title_fullStr | Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features |
title_full_unstemmed | Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features |
title_short | Bilateral Habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features |
title_sort | bilateral habenula deep brain stimulation for treatment-resistant depression: clinical findings and electrophysiological features |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813927/ https://www.ncbi.nlm.nih.gov/pubmed/35115488 http://dx.doi.org/10.1038/s41398-022-01818-z |
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