Major Depressive Disorder continues to remain one of the most prevalent psychiatric diseases globally. Despite multiple trials of conventional therapies, a subset of patients fail to have adequate benefit to treatment. Deep brain stimulation (DBS) is a promising treatment in this difficult to treat population and has shown strong antidepressant effects across multiple cohorts. Nearly two decades of work have provided insights into the potential for chronic focal stimulation in precise brain targets to modulate pathological brain circuits that are implicated in the pathogenesis of depression. In this paper we review the rationale that prompted the selection of various brain targets for DBS, their subsequent clinical outcomes and common adverse events reported. We additionally discuss some of the pitfalls and challenges that have prevented more widespread adoption of this technology as well as future directions that have shown promise in improving therapeutic efficacy of DBS in the treatment of depression.
Keyphrases
- deep brain stimulation
- major depressive disorder
- parkinson disease
- obsessive compulsive disorder
- clinical trial
- bipolar disorder
- depressive symptoms
- resting state
- mental health
- newly diagnosed
- ejection fraction
- combination therapy
- white matter
- replacement therapy
- end stage renal disease
- brain injury
- functional connectivity
- risk assessment
- smoking cessation