Аннотация
Treatment-resistant depression is a severely disabling disorder with
no proven treatment options once multiple medications, psychotherapy,
and electroconvulsive therapy have failed. Based on our preliminary
observation that the subgenual cingulate region (Brodmann area 25)
is metabolically overactive in treatment-resistant depression, we
studied whether the application of chronic deep brain stimulation
to modulate BA25 could reduce this elevated activity and produce
clinical benefit in six patients with refractory depression. Chronic
stimulation of white matter tracts adjacent to the subgenual cingulate
gyrus was associated with a striking and sustained remission of depression
in four of six patients. Antidepressant effects were associated with
a marked reduction in local cerebral blood flow as well as changes
in downstream limbic and cortical sites, measured using positron
emission tomography. These results suggest that disrupting focal
pathological activity in limbic-cortical circuits using electrical
stimulation of the subgenual cingulate white matter can effectively
reverse symptoms in otherwise treatment-resistant depression.
- adult,deep
- aged,pilot
- brain
- cinguli,gyrus
- cinguli:
- disorder,
- major,depressive
- major:
- metabolism,depressive
- metabolism,gyrus
- methods,depressive
- methods,psychiatric
- projects,positron-emission
- psychology,depressive
- rating
- scales
- status
- stimulation,deep
- stimulation:
- surgery,humans,male,middle
- therapy,female,gyrus
- tomography,positron-emission
- tomography:
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