Case Report: Lateral Habenula Deep Brain Stimulation for Treatment-Resistant Depression

Wang, Zhiyan; Cai, Xiaodong; Qiu, Rirang; Yao, Chen; Tian, Ye; Gong, Chen; Zhang, Yingli; Xu, Bin; Zhang, Doudou; Zang, Yu; Liu, Jiali; Peng, Bo; Li, Luming

doi:10.3389/fpsyt.2020.616501

Cited by 27 publications

(29 citation statements)

References 27 publications

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“…Specific patterns of acute and chronic electrical stimulation ( Li et al, 2011 ; Meng et al, 2011 ; Tchenio et al, 2017 ) or pharmacological inhibition ( Winter et al, 2011 ) of the habenula attenuate MDD-like behaviors in animal models. This is further supported by a recent case report study showing improvement of symptoms with deep brain stimulation of the habenula in treatment-resistant MDD patients ( Wang et al, 2020 ). In contrast, human neuroimaging and postmortem studies have been inconsistent.…”

Section: Habenula In Adhd and Mddsupporting

confidence: 69%

The Habenula in the Link Between ADHD and Mood Disorder

Lee

Goto

2021

Front. Behav. Neurosci.

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Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset, neurodevelopmental disorder, whereas major depressive disorder (MDD) is a mood disorder that typically emerges in adulthood. Accumulating evidence suggests that these seemingly unrelated psychiatric disorders, whose symptoms even appear antithetical [e.g., psychomotor retardation in depression vs. hyperactivity (psychomotor acceleration) in ADHD], are in fact associated with each other. Thus, individuals with ADHD exhibit high comorbidity with MDD later in life. Moreover, genetic studies have shown substantial overlaps of susceptibility genes between ADHD and MDD. Here, we propose a novel and testable hypothesis that the habenula, the epithalamic brain region important for the regulation of monoamine transmission, may be involved in both ADHD and MDD. The hypothesis suggests that an initially hypoactive habenula during childhood in individuals with ADHD may undergo compensatory changes during development, priming the habenula to be hyperactive in response to stress exposure and thereby increasing vulnerability to MDD in adulthood. Moreover, we propose a new perspective on habenular deficits in psychiatric disorders that consider the habenula a neural substrate that could explain multiple psychiatric disorders.

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Section: Habenula In Adhd and Mddsupporting

confidence: 69%

The Habenula in the Link Between ADHD and Mood Disorder

Lee

Goto

2021

Front. Behav. Neurosci.

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“…The full text search of the remaining 75 studies 25 did not target the Hb, 44 described preclinical experiments and one study described data reported in an earlier manuscript. After screening, this systematic review identified five articles (Table 2) (47,(63)(64)(65)(66) that satisfied the inclusion criteria. These articles reported the results of DBS targeting the Hb for four different indications: schizophrenia (63), treatment resistant major depressive disorder (TRD) (47,65,66), OCD (45) and BD (46).…”

Section: Resultsmentioning

confidence: 99%

“…After screening, this systematic review identified five articles (Table 2) (47,(63)(64)(65)(66) that satisfied the inclusion criteria. These articles reported the results of DBS targeting the Hb for four different indications: schizophrenia (63), treatment resistant major depressive disorder (TRD) (47,65,66), OCD (45) and BD (46).…”

Section: Resultsmentioning

confidence: 99%

“…Four of the five were single case studies (47,(64)(65)(66), one was a small case series of two patients (63). Clinical changes ranged from −9.5 to 100% symptom improvement in the overall six patients treated, with positive clinical outcome (improvement ≧31.7%) reported in 5 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Indeed, recent fMRI studies have characterized brain-wide fingerprints of optimal subthalamic DBS for PD with respect to stimulation parameters such as contact, voltage, and frequency (96,97). To this end, Zhang and colleagues used fMRI at various settings compared to a healthy control group (65) while Wang and colleagues conducted LFP recordings paired with a systematic assessment of the effects of stimulation (66).…”

Section: Discussionmentioning

confidence: 99%

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Deep Brain Stimulation of the Habenula: Systematic Review of the Literature and Clinical Trial Registries

et al. 2021

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The habenula is a small bilateral epithalamic structure that plays a key role in the regulation of the main monoaminergic systems. It is implicated in many aspects of behavior such as reward processing, motivational behavior, behavioral adaptation, and sensory integration. A role of the habenula has been indicated in the pathophysiology of a number of neuropsychiatric disorders such as depression, addiction, obsessive-compulsive disorder, and bipolar disorder. Neuromodulation of the habenula using deep brain stimulation (DBS) as potential treatment has been proposed and a first successful case of habenula DBS was reported a decade ago. To provide an overview of the current state of habenula DBS in human subjects for the treatment of neuropsychiatric disorders we conducted a systematic review of both the published literature using PUBMED and current and past registered clinical trials using ClinicalTrials.gov as well as the International Clinical Trials Registry Platform. Using PRISMA guidelines five articles and five registered clinical trials were identified. The published articles detailed the results of habenula DBS for the treatment of schizophrenia, depression, obsessive-compulsive disorder, and bipolar disorder. Four are single case studies; one reports findings in two patients and positive clinical outcome is described in five of the six patients. Of the five registered clinical trials identified, four investigate habenula DBS for the treatment of depression and one for obsessive-compulsive disorder. One trial is listed as terminated, one is recruiting, two are not yet recruiting and the status of the fifth is unknown. The planned enrollment varies between 2 to 13 subjects and four of the five are open label trials. While the published studies suggest a potential role of habenula DBS for a number of indications, future trials and studies are necessary. The outcomes of the ongoing clinical trials will provide further valuable insights. Establishing habenula DBS, however, will depend on successful randomized clinical trials to confirm application and clinical benefit of this promising intervention.

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Recent Advances in Habenula Imaging Technology: A Comprehensive Review

Bian

Zhang

Wong

et al. 2023

Magnetic Resonance Imaging

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The habenula (Hb) is involved in many natural human behaviors, and the relevance of its alterations in size and neural activity to several psychiatric disorders and addictive behaviors has been presumed and investigated in recent years using magnetic resonance imaging (MRI). Although the Hb is small, an increasing number of studies have overcome the difficulties in MRI. Conventional structural‐based imaging also has great defects in observing the Hb contrast with adjacent structures. In addition, more and more attention should be paid to the Hb's functional, structural, and quantitative imaging studies. Several advanced MRI methods have recently been employed in clinical studies to explore the Hb and its involvement in psychiatric diseases. This review summarizes the anatomy and function of the human Hb; moreover, it focuses on exploring the human Hb with noninvasive MRI approaches, highlighting strategies to overcome the poor contrast with adjacent structures and the need for multiparametric MRI to develop imaging markers for diagnosis and treatment follow‐up.Level of Evidence3Technical Efficacy Stage2

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Case Report: Lateral Habenula Deep Brain Stimulation for Treatment-Resistant Depression

Cited by 27 publications

References 27 publications

The Habenula in the Link Between ADHD and Mood Disorder

The Habenula in the Link Between ADHD and Mood Disorder

Deep Brain Stimulation of the Habenula: Systematic Review of the Literature and Clinical Trial Registries

Recent Advances in Habenula Imaging Technology: A Comprehensive Review

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