Deep Brain Stimulation to Reward Circuitry Alleviates Anhedonia in Refractory Major Depression

@article{Schlaepfer2008DeepBS,
  title={Deep Brain Stimulation to Reward Circuitry Alleviates Anhedonia in Refractory Major Depression},
  author={Thomas E. Schlaepfer and Michael X. Cohen and Caroline Frick and Markus Kosel and Daniela Brodesser and Nikolai Axmacher and Alexius Young Joe and M. Kreft and Doris Lenartz and Volker Sturm},
  journal={Neuropsychopharmacology},
  year={2008},
  volume={33},
  pages={368-377}
}
Deep brain stimulation (DBS) to different sites allows interfering with dysfunctional network function implicated in major depression. Because a prominent clinical feature of depression is anhedonia—the inability to experience pleasure from previously pleasurable activities—and because there is clear evidence of dysfunctions of the reward system in depression, DBS to the nucleus accumbens might offer a new possibility to target depressive symptomatology in otherwise treatment-resistant… Expand
Nucleus Accumbens Deep Brain Stimulation Decreases Ratings of Depression and Anxiety in Treatment-Resistant Depression
BACKGROUND While most patients with depression respond to combinations of pharmacotherapy, psychotherapy, and electroconvulsive therapy (ECT), there are patients requiring other treatments. DeepExpand
Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Treatment-Resistant Depression
TLDR
Deep brain stimulation of the VC/VS offers promise for the treatment of refractory major depression. Expand
Deep Brain Stimulation of the Human Reward System as a Putative Treatment for Refractory Major Depression
TLDR
The first evidence on a small sample studied for up to 4 years has proven that NAc DBS induces stable, sustained antidepressant effects in 50 % of patients, and no fundamental ethical objections to the use of DBS in psychiatric disorders have been put forward. Expand
Rapid Effects of Deep Brain Stimulation for Treatment-Resistant Major Depression
TLDR
Preliminary findings suggest that bilateral stimulation of the supero-lateral branch of the medial forebrain bundle may significantly reduce symptoms in treatment-resistant major depressive disorder. Expand
The nucleus accumbens: a target for deep brain stimulation in resistant major depressive disorder
TLDR
DBS seems to be a promising technique in resistant MDD treatment according to encouraging recent studies, and the role of Nucleus accumbens (Nac) as a target for treatment is explored. Expand
Deep Brain Stimulation for Treatment-Resistant Depression: Review of the
Chronic Major depression is one of the most debilitating psychiatric disorders ; 8-13% of patients are treatment resistant. DBS has been applied to the following targets: Subcallosal cingulate gyrusExpand
Deep Brain Stimulation of the Human Reward System for Major Depression—Rationale, Outcomes and Outlook
TLDR
This overview summarizes research on the mechanisms of brain networks with respect to psychiatric diseases and—as a novelty—extrapolates to the role of the reward system in DBS for patients with treatment-resistant depression. Expand
Deep Brain Stimulation for Major Depression—Steps on a Long and Winding Road
Most patients with psychiatric disorders respond to combinations of psychotherapy and psychopharmacotherapy; however, some patients experience little, if any, benefit even after many years ofExpand
Limbic versus cognitive target for deep brain stimulation in treatment-resistant depression: Accumbens more promising than caudate
TLDR
A preliminary trial of DBS of two potential brain targets in chronic TRD: the nucleus accumbens (Acb) and, in the event of failure, the caudate nucleus, suggests that Acb is a more promising target than the caUDate. Expand
Deep brain stimulation increases impulsivity in two patients with obsessive–compulsive disorder
TLDR
Two patients with treatment-refractory OCD in whom increased voltage of deep brain stimulation targeted at the nucleus accumbens increased impulsivity are described, underline the importance of a careful clinical assessment of impulsive behaviours during DBS for OCD. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 71 REFERENCES
Deep Brain Stimulation for Treatment-Resistant Depression
TLDR
It is suggested that disrupting focal pathological activity in limbic-cortical circuits using electrical stimulation of the subgenual cingulate white matter can effectively reverse symptoms in otherwise treatment-resistant depression. Expand
Deep brain stimulation for refractory obsessive-compulsive disorder
TLDR
It appears that DBS has potential value for treating refractory psychiatric disorders, but additional development work is needed before the procedure is utilized outside of carefully controlled research protocols. Expand
Mechanisms and the Current State of Deep Brain Stimulation in Neuropsychiatry
TLDR
Deep brain stimulation precisely targets neuroanatomical targets deep within the brain that are proposed to be centrally involved in the pathophysiology of some neuropsychiatric illnesses, offering the advantages of reversibility and adjustability. Expand
A functional neuroimaging investigation of deep brain stimulation in patients with obsessive-compulsive disorder.
TLDR
Test hypotheses regarding changes in regional cerebral blood flow during acute DBS at the VC/VS target in patients with OCD who were participating in a clinical DBS trial found significant activation of the orbitofrontal cortex, anterior cingulate cortex, striatum, globus pallidus, and thalamus. Expand
Functional neuroanatomical substrates of altered reward processing in major depressive disorder revealed by a dopaminergic probe.
TLDR
Dopamine-related neuroanatomical substrates are involved in altered reward processing in major depressive disorder, shedding light on the neurobiology of the anhedonic symptoms in MDD and suggesting these substrates as future therapeutic targets. Expand
The nucleus accumbens: a target for deep brain stimulation in obsessive–compulsive- and anxiety-disorders
TLDR
The shell region of the right nucleus accumbens is chosen as target for deep brain stimulation (DBS) in a pilot-series of four patients with severe obsessive-compulsive- and anxiety-disorders, with significant reduction in severity of symptoms. Expand
Modulating limbic-cortical circuits in depression: targets of antidepressant treatments.
  • H. Mayberg
  • Psychology, Medicine
  • Seminars in clinical neuropsychiatry
  • 2002
TLDR
A cortical-limbic network model of depression is used and network dysfunction combined with ongoing intrinsic compensatory processes is seen to explain the heterogeneity of depressive symptoms observed clinically, as well as variations in pretreatment scan patterns. Expand
Efficiency and safety of bilateral contemporaneous pallidal stimulation (deep brain stimulation) in levodopa-responsive patients with Parkinson's disease with severe motor fluctuations: a 2-year follow-up review.
TLDR
Bilateral pallidal DBS is safe and efficient in patients who have levodopa-responsive parkinsonism with severe fluctuations, and major improvements in motor score, ADL score, and off time persisted beyond 2 years after the operation, but signs of decreased efficacy started to be seen after 12 months. Expand
Limbic-cortical dysregulation: a proposed model of depression.
  • H. Mayberg
  • Psychology, Medicine
  • The Journal of neuropsychiatry and clinical neurosciences
  • 1997
TLDR
A working model of depression implicating failure of the coordinated interactions of a distributed network of limbic-cortical pathways is proposed to facilitate continued integration of clinical imaging findings with complementary neuroanatomical, neurochemical, and electrophysiological studies in the investigation of the pathogenesis of affective disorders. Expand
Dysfunction of ventral striatal reward prediction in schizophrenia
TLDR
In unmedicated schizophrenic patients, a high striatal dopamine turnover may increase the "noise" in the reward system, thus interfering with the neuronal processing of reward-predicting cues by phasic dopamine release, which may contribute to negative symptoms as such as anhedonia, apathy, and loss of drive and motivation. Expand
...
1
2
3
4
5
...