Bilateral Epidural Prefrontal Cortical Stimulation for Treatment-Resistant Depression

Nahas, Ziad; Anderson, Berry; Borckardt, Jeffery J.; Arana, Ashley; George, Mark S.; Reeves, Scott; Takács, István

doi:10.1016/j.biopsych.2009.08.021

Cited by 96 publications

(66 citation statements)

References 58 publications

(66 reference statements)

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“…In addition to the traditional ECT, repetitive transcranial magnetic therapy, magnetic seizure therapy, vagus nerve stimulation (VNS), and deep brain stimulation (DBS) have become alternative nonpharmacological treatment options for many psychiatric patients. Other experimental procedures, such as epidural prefrontal cortical stimulation, are under investigation [11] .…”

Section: Introductionmentioning

confidence: 99%

The Application of Vagus Nerve Stimulation and Deep Brain Stimulation in Depression

Mohr

Rodríguez

A³

et al. 2011

Neuropsychobiology

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Despite the progress in the pharmacotherapy of depression, there is a substantial proportion of treatment-resistant patients. Recently, reversible invasive stimulation methods, i.e. vagus nerve stimulation (VNS) and deep brain stimulation (DBS), have been introduced into the management of treatment-resistant depression (TRD). VNS has already received regulatory approval for TRD. This paper reviews the available clinical evidence and neurobiology of VNS and DBS in TRD. The principle of VNS is a stimulation of the left cervical vagus nerve with a programmable neurostimulator. VNS was examined in 4 clinical trials with 355 patients. VNS demonstrated steadily increasing improvement with full benefit after 6–12 months, sustained up to 2 years. Patients who responded best had a low-to-moderate antidepressant resistance. However, the primary results of the only controlled trial were negative. DBS involves stereotactical implantation of electrodes powered by a pulse generator into the specific brain regions. For depression, the targeted areas are the subthalamic nucleus, internal globus pallidus, ventral internal capsule/ventral striatum, the subgenual cingulated region, and the nucleus accumbens. Antidepressant effects of DBS were examined in case series with a total number of 50 TRD patients. Stimulation of different brain regions resulted in a reduction of depressive symptoms. The clinical data on the use of VNS and DBS in TRD are encouraging. The major contribution of the methods is a novel approach that allows for precise targeting of the specific brain areas, nuclei and circuits implicated in the etiopathogenesis of neuropsychiatric disorders. For clinical practice, it is necessary to identify patients who may best benefit from VNS or DBS.

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Section: Introductionmentioning

confidence: 99%

The Application of Vagus Nerve Stimulation and Deep Brain Stimulation in Depression

Mohr

Rodríguez

A³

et al. 2011

Neuropsychobiology

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“…Recently, a longitudinal functional MRI study reported MPFC to be a biomarker for risk of relapse in patients with depression, probably, it is related to over activation in response to rumination thoughts ( Farb, Anderson, Bloch & Segal, 2011a). Nevertheless, abnormalities in this region has found to be restored successful after antidepressants treatment (Nahas et al, 2010). Inconsistently, some studies reported increased amygdala metabolism to be associated with depression severity (Abercrombie et al, 1999;Drevets et al, 2002).…”

Section: Description Of Demographic and Clinical Characteristicsmentioning

confidence: 99%

Major Depressive Disorder and Heroin-dependent Patients Share Decreased Frontal Gray Matter Volumes: A Voxel-Based Morphometry Study

Mwansisya¹,

Zhang²,

Wang³

et al. 2016

Int J Emerg Ment Health

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“…A postoperative computed tomography of the head is fused with the preoperative MRI to assure appropriate placement [69]. Kopell et al [69] and Nahas et al [80] have shown the feasibility of these implants. Stimulation was well tolerated, with the expected, yet low, chance of surgical complications of bleeding and infection.…”

Section: Depressionmentioning

confidence: 99%

Use of Cortical Stimulation in Neuropathic Pain, Tinnitus, Depression, and Movement Disorders

Panov

Kopell

2014

Neurotherapeutics

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Medical treatment must strike a balance between benefit and risk. As the field of neuromodulation develops, decreased invasiveness, in combination with maintenance of efficacy, has become a goal. We provide a review of the history of cortical stimulation from its origins to the current state. The first part discusses neuropathic pain and the nonpharmacological treatment options used. The second part covers transitions to tinnitus, believed by many to be another deafferentation disorder, its classification, and treatment. The third part focuses on major depression. The fourth section concludes with the discussion of the use of cortical stimulation in movement disorders. Each part discusses the development of the field, describes the current care protocols, and suggests future avenues for research needed to advance neuromodulation.

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Bilateral Epidural Prefrontal Cortical Stimulation for Treatment-Resistant Depression

Cited by 96 publications

References 58 publications

The Application of Vagus Nerve Stimulation and Deep Brain Stimulation in Depression

The Application of Vagus Nerve Stimulation and Deep Brain Stimulation in Depression

Major Depressive Disorder and Heroin-dependent Patients Share Decreased Frontal Gray Matter Volumes: A Voxel-Based Morphometry Study

Use of Cortical Stimulation in Neuropathic Pain, Tinnitus, Depression, and Movement Disorders

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