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deep brain stimulation depression

Sabato Santaniello, John T Gale, Sridevi V Sarma
Over the last 30 years, deep brain stimulation (DBS) has been used to treat chronic neurological diseases like dystonia, obsessive-compulsive disorders, essential tremor, Parkinson's disease, and more recently, dementias, depression, cognitive disorders, and epilepsy. Despite its wide use, DBS presents numerous challenges for both clinicians and engineers. One challenge is the design of novel, more efficient DBS therapies, which are hampered by the lack of complete understanding about the cellular mechanisms of therapeutic DBS...
March 20, 2018: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
Anand Rughani, Jason M Schwalb, Christos Sidiropoulos, Julie Pilitsis, Adolfo Ramirez-Zamora, Jennifer A Sweet, Sandeep Mittal, Alberto J Espay, Jorge Gonzalez Martinez, Aviva Abosch, Emad Eskandar, Robert Gross, Ron Alterman, Clement Hamani
QUESTION 1: Is bilateral subthalamic nucleus deep brain stimulation (STN DBS) more, less, or as effective as bilateral globus pallidus internus deep brain stimulation (GPi DBS) in treating motor symptoms of Parkinson's disease, as measured by improvements in Unified Parkinson's Disease Rating Scale, part III (UPDRS-III) scores? RECOMMENDATION: Given that bilateral STN DBS is at least as effective as bilateral GPi DBS in treating motor symptoms of Parkinson's disease (as measured by improvements in UPDRS-III scores), consideration can be given to the selection of either target in patients undergoing surgery to treat motor symptoms...
March 12, 2018: Neurosurgery
Bettina H Bewernick, Hannah M Kilian, Klaudius Schmidt, Ruth E Reinfeldt, Sarah Kayser, Volker A Coenen, Sebastian Markett, Thomas E Schlaepfer
BACKGROUND: Reports of changes in patients' social behavior during deep brain stimulation (DBS) raised the question whether DBS induces changes in personality. This study explored if (1) DBS is associated with changes in personality in patients suffering from treatment-resistant depression (TRD), (2) how personality dimensions and depression are associated, and (3) if TRD patients' self-ratings of personality are valid. METHODS: TRD patients were assessed before DBS (n = 30), 6 months (t2, n = 21), 2 (t3, n = 17) and 5 years (t4, n = 11) after the initiation of DBS of the supero-lateral branch of the medial forebrain bundle (slMFB-DBS)...
March 1, 2018: Psychological Medicine
Fabian Rottstädt, Pengfei Han, Kerstin Weidner, Julia Schellong, Sylvia Wolff-Stephan, Timmy Strauß, Hagen Kitzler, Thomas Hummel, Ilona Croy
BACKGROUND: Removal of the olfactory bulb (OB) leads to depression like behavior in rodents. A link between depression and olfactory function is also established in humans. We hypothesized that the human OB volume relates to depressive state and tested whether such a potential coherence is moderated by structural alterations in other brain regions. METHODS: Eighty-three participants (32 patients with major depression and 51 matched healthy controls) underwent structural MR scanning...
February 28, 2018: Human Brain Mapping
M P Dandekar, A J Fenoy, A F Carvalho, J C Soares, J Quevedo
Although deep brain stimulation (DBS) is an established treatment choice for Parkinson's disease (PD), essential tremor and movement disorders, its effectiveness for the management of treatment-resistant depression (TRD) remains unclear. Herein, we conducted an integrative review on major neuroanatomical targets of DBS pursued for the treatment of intractable TRD. The aim of this review article is to provide a critical discussion of possible underlying mechanisms for DBS-generated antidepressant effects identified in preclinical studies and clinical trials, and to determine which brain target(s) elicited the most promising outcomes considering acute and maintenance treatment of TRD...
February 27, 2018: Molecular Psychiatry
Rebecca L Achey, Erin Yamamoto, Daniel Sexton, Christine Hammer, Bryan S Lee, Robert S Butler, Nicolas R Thompson, Sean J Nagel, Andre G Machado, Darlene A Lobel
OBJECTIVE Deep brain stimulation (DBS) is an effective therapy for movement disorders such as idiopathic Parkinson's disease (PD) and essential tremor (ET). However, some patients who demonstrate benefit on objective motor function tests do not experience postoperative improvement in depression or anxiety, 2 important components of quality of life (QOL). Thus, to examine other possible explanations for the lack of a post-DBS correlation between improved objective motor function and decreased depression or anxiety, the authors investigated whether patient perceptions of motor symptom severity might contribute to disease-associated depression and anxiety...
February 23, 2018: Journal of Neurosurgery
Marie Abbes, Eugénie Lhommée, Stéphane Thobois, Hélène Klinger, Emmanuelle Schmitt, Amélie Bichon, Anna Castrioto, Jing Xie, Valérie Fraix, Andrea Kistner, Pierre Pélissier, Éric Seigneuret, Stéphan Chabardès, Patrick Mertens, Emmanuel Broussolle, Elena Moro, Paul Krack
BACKGROUND: Reports on behavioural outcomes after subthalamic nucleus deep brain stimulation in Parkinson's disease are controversial and limited to short-term data. Long-term observation in a large cohort allows a better counselling and management. METHODS: To determine whether a long-term treatment with subthalamic stimulation induces or reduces impulse control behaviours, neuropsychiatric fluctuations and apathy, 69 patients treated with subthalamic stimulation are prospectively and retrospectively assessed using Ardouin Scale of Behavior in Parkinson's Disease before and after 3-10 years of stimulation...
February 7, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Stephanie Thiele, Luciano Furlanetti, Lisa-Marie Pfeiffer, Volker A Coenen, Máté D Döbrössy
BACKGROUND: Clinical trials of supra-lateral medial forebrain bundle (MFB) Deep Brain Stimulation (DBS) in treatment resistant major depressive patients have shown rapid and long-term benefits. OBJECTIVE/HYPOTHESIS: The study used Flinders Sensitive Line (FSL) rats with previously identified depressive-like phenotype to assess the range of behavior modification achieved by MFB DBS. METHODS: Male FSL and wild-type Sprague-Dawley rats as Controls were tested on mood/anxiety/exploration, cognitive and motor behaviors...
February 8, 2018: Experimental Neurology
Fady Girgis, Darrin J Lee, Amir Goodarzi, Jochen Ditterich
Piaget's genetic epistemology has provided the constructivist approach upon which child developmental theories were founded, in that infants are thought to progress through distinct cognitive stages until they reach maturity in their early 20's. However, it is now well established that cognition continues to develop after early adulthood, and several "neo-Piagetian" theories have emerged in an attempt to better characterize adult cognitive development. For example, Kegan's Constructive Developmental Theory (CDT) argues that the thought processes used by adults to construct their reality change over time, and reaching higher stages of cognitive development entails becoming objectively aware of emotions and beliefs that were previously in the realm of the subconscious...
2018: Frontiers in Neuroscience
Volker M Tronnier, Dirk Rasche, Veronika Thorns, Daniel Alvarez-Fischer, Thomas F Münte, Bartosz Zurowski
Obese individuals share behavioral characteristics with drug/alcohol addicts as well as obsessive compulsive disease. Deep brain stimulation (DBS) has been used successfully in these disorders, thus warranting an evaluation in obesity. A woman with treatment-resistant depression as well as severe obesity was selected for DBS of the nucleus accumbens (NAcc) bilaterally with depression being the primary and obesity being the secondary target of treatment. Compared to earlier bariatric surgery, the patient showed accelerated weight loss after DBS...
February 1, 2018: Neurocase
Ausaf A Bari, Charles B Mikell, Aviva Abosch, Sharona Ben-Haim, Robert J Buchanan, Allen W Burton, Stephen Carcieri, G Rees Cosgrove, Pierre-Francois D'Haese, Zafiris Jeffrey Daskalakis, Emad N Eskandar, Jason L Gerrard, Wayne K Goodman, Benjamin David Greenberg, Robert E Gross, Clement Hamani, Zelma H T Kiss, Peter Konrad, Brian H Kopell, Lothar Krinke, Jean-Philippe Langevin, Andres M Lozano, Donald Malone, Helen S Mayberg, Jonathan P Miller, Parag G Patil, DeLea Peichel, Erika A Petersen, Ali R Rezai, R Mark Richardson, Patricio Riva-Posse, Tejas Sankar, Jason M Schwalb, Helen Blair Simpson, Konstantin Slavin, Paul H Stypulkowski, Tor Tosteson, Peter Warnke, Jon T Willie, Kareem A Zaghloul, Joseph S Neimat, Nader Pouratian, Sameer A Sheth
OBJECTIVE: Refractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016...
January 25, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Brady Lonergan, Eliza Nguyen, Cara Lembo, Carrie Hinchman, Oscar G Morales, Daniel Z Press, Alvaro Pascual-Leone, Adam P Stern
Four transcranial magnetic stimulation (TMS) devices are currently approved for use in treatment-resistant depression. The authors present the first data-driven study examining the patient- and technician-experience using three of these distinct devices. A retrospective survey design with both patient and technician arms was utilized. The study population included patients who received TMS for treatment-resistant depression at the Berenson Allen Center for Noninvasive Brain Stimulation for the first time between 2013 and 2016 and technicians who worked in the program from 2009 to 2017...
January 25, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
Steven A Rasmussen, Georg Norén, Benjamin D Greenberg, Richard Marsland, Nicole C McLaughlin, Paul J Malloy, Stephen P Salloway, David R Strong, Jane L Eisen, Michael A Jenike, Scott L Rauch, Lee Baer, Christer Lindquist
BACKGROUND: Despite the development of effective pharmacologic and cognitive behavioral treatments for obsessive-compulsive disorder (OCD), some patients continue to be treatment-refractory and severely impaired. Fiber tracts connecting orbitofrontal and dorsal anterior cingulate cortex with subcortical nuclei have been the target of neurosurgical lesions as well as deep brain stimulation in these patients. We report on the safety and efficacy of ventral gamma capsulotomy for patients with intractable OCD...
December 15, 2017: Biological Psychiatry
Philip S Lee, Donald J Crammond, R Mark Richardson
The concept of deep brain stimulation (DBS) for Parkinson's disease (PD) was introduced over 20 years ago, but our understanding of the nuances of this procedure continues to improve. The average motor outcomes of internal segment of the globus pallidus (GPi) and subthalamic nucleus (STN) DBS appear to be similar, although GPi DBS may allow greater recovery of verbal fluency and may provide greater relief of depression symptoms and improvement in the quality of life, and STN DBS appears more likely to result in decrease in levodopa equivalent doses...
2018: Progress in Neurological Surgery
Tim A M Bouwens van der Vlis, Olaf E M G Schijns, Frédéric L W V J Schaper, Govert Hoogland, Pieter Kubben, Louis Wagner, Rob Rouhl, Yasin Temel, Linda Ackermans
Despite the use of first-choice anti-epileptic drugs and satisfactory seizure outcome rates after resective epilepsy surgery, a considerable percentage of patients do not become seizure free. ANT-DBS may provide for an alternative treatment option in these patients. This literature review discusses the rationale, mechanism of action, clinical efficacy, safety, and tolerability of ANT-DBS in drug-resistant epilepsy patients. A review using systematic methods of the available literature was performed using relevant databases including Medline, Embase, and the Cochrane Library pertaining to the different aspects ANT-DBS...
January 6, 2018: Neurosurgical Review
Gunnar Gaede, Marina Tiede, Ina Lorenz, Alexander U Brandt, Caspar Pfueller, Jan Dörr, Judith Bellmann-Strobl, Sophie K Piper, Yiftach Roth, Abraham Zangen, Sven Schippling, Friedemann Paul
Objective: To conduct a randomized, sham-controlled phase I/IIa study to evaluate the safety and preliminary efficacy of deep brain H-coil repetitive transcranial magnetic stimulation (rTMS) over the prefrontal cortex (PFC) and the primary motor cortex (MC) in patients with MS with fatigue or depression (NCT01106365). Methods: Thirty-three patients with MS were recruited to undergo 18 consecutive rTMS sessions over 6 weeks, followed by follow-up (FU) assessments over 6 weeks...
January 2018: Neurology® Neuroimmunology & Neuroinflammation
Dongxin Wang, Xuejun Liu, Bin Zhou, Weiping Kuang, Tiansheng Guo
Deep brain stimulation is a method that involves using an electric stimulus on a specific target in the brain with stereotaxis. It is a minimally invasive, safe, adjustable and reversible nerve involvement technology. At present, this technique is widely applied to treat movement disorders and has produced promising effects on mental symptoms, including combined anxiety and depression. Deep brain stimulation has therefore been employed as a novel treatment for depression, obsessive-compulsive disorder, habituation, Tourette's syndrome, presenile dementia, anorexia nervosa and other refractory mental illnesses...
January 2018: Experimental and Therapeutic Medicine
Derek G Southwell, Martin J Rutkowski, Marta San Luciano, Caroline Racine, Jill Ostrem, Philip A Starr, Paul S Larson
INTRODUCTION: The Veterans Affairs Cooperative Study Program 468 study (CSP 468) produced significant findings regarding deep brain stimulation (DBS) target selection for Parkinson's Disease (PD) treatment, yet its impact on clinical practices has not been described. Here we assess how CSP 468 influenced target selection at a high-volume movement disorders treatment center. METHODS: We compared DBS target site selection between 4-year periods that immediately preceded and followed CSP 468 publication...
December 12, 2017: Parkinsonism & related Disorders
Ki Sueng Choi, Angela M Noecker, Patricio Riva-Posse, Justin K Rajendra, Robert E Gross, Helen S Mayberg, Cameron C McIntyre
BACKGROUND: Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an emerging experimental therapy for treatment-resistant depression. New developments in SCC DBS surgical targeting are focused on identifying specific axonal pathways for stimulation that are estimated from preoperatively collected diffusion-weighted imaging (DWI) data. However, brain shift induced by opening burr holes in the skull may alter the position of the target pathways. OBJECTIVES: Quantify the effect of electrode location deviations on tractographic representations for stimulating the target pathways using longitudinal clinical imaging datasets...
December 6, 2017: Brain Stimulation
M Soledad Cepeda, Jenna Reps, Daniel Fife, Clair Blacketer, Paul Stang, Patrick Ryan
BACKGROUND: Depression that does not respond to antidepressants is treatment-resistant depression (TRD). TRD definitions include assessments of treatment response, dose and duration, and implementing these definitions in claims databases can be challenging. We built a data-driven TRD definition and evaluated its performance. METHODS: We included adults with depression, ≥1 antidepressant, and no diagnosis of mania, dementia, or psychosis. Subjects were stratified into those with and without proxy for TRD...
December 15, 2017: Depression and Anxiety
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