Subcallosal Cingulate Cortex Deep Brain Stimulation for Treatment-Resistant Depression: A Systematic Review

Abstract

BackgroundDeep brain stimulation (DBS) is considered a relatively new and still experimental therapeutic modality for treatment-resistant depression (TRD). There is clinical evidence to suggest that stimulation of the subcallosal cingulate cortex (SCC) involved in the pathogenesis of TRD may exert an antidepressant effect.AimsTo conduct a systematic review of current studies, such as randomized clinical trials (RCTs), open-label trials, and placebo-controlled trials, examining SCC DBS for TRD in human participants.MethodA formal review of the academic literature was performed using the Medical Literature, Analysis, and Retrieval System Online (MEDLINE) and Cochrane Central Register of Controlled Trials (CENTRAL) databases. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Suitable studies were screened and assessed based on patient characteristics, clinical outcomes, adverse events related to DBS, and the stereotactic technique used to guide the implantation of DBS electrodes.ResultsThe literature search identified 14 clinical studies that enrolled a total of 230 patients with TRD who underwent SCC DBS. The average duration of follow-up was 14 months (range 6–24 months). The response and remission rates at the last available follow-up visit ranged between 23–92% and 27–66.7%, respectively.ConclusionThe current results of SCC DBS are limited by the relatively small number of patients treated worldwide. Nevertheless, studies to date suggest that SCC can be a promising and efficacious target for DBS, considering the high response and remission rates among patients with TRD. The adverse events of SCC DBS are usually transient and stimulation-induced.

Individual-level deviations from normative brain morphology in violence, psychosis, and psychopathy

“…In addition, HoV showed significantly more negative deviations in the right subcallosal gyrus area ( d =0.98). The subcallosal gyrus is located adjacent to the anterior cingulate and has been associated with empathy (Rankin et al, 2006) and depression (Dunlop et al, 2023; Sobstyl, Kupryjaniuk, Prokopienko, & Rylski, 2022). Interestingly, the subcallosal gyrus is by some considered as a part of the anterior cingulate (Hamani et al, 2011), which is part of a neural network involved in aggression with e.g.…”

Use of deep brain stimulation for treatment-resistant depression – review of main stimulation targets

“…In this case the alleviation of major depression was gradual and profound, with significant decrease in MADRS, HAM-D and HAMA scores, allowing the patient to return to family and social life [47]. A sample group of 5 female patients with TRD took part in study conducted by Fitzgerald et al Basing on HRDS score, the response rate at 6 months, 12 months and last followup was 20%, 40% and 60%, respectively [48]. Bigger group was examined by Neumann et al, with patients with TRD and obsessive-compulsive disorder taking part.…”

Perceived parenting styles and incidence of major depressive disorder: results from a 6985 freshmen cohort study

“…MDD is diagnosed when either depressed mood or a lack of pleasure in usual activities is present continuously for 2 weeks or more and is accompanied by decreased energy, anhedonia, insomnia or hypersomnia, and psychomotor agitation or retardation [3,4]. Among numerous factors predicting the onset of MDD, baseline depressive symptoms is one of them [5,6].…”