Deep brain stimulation interruption and suicidality
Andrew Howard, Christopher R. Honey, Trevor A. Hurwitz, Magdalena Ilcewicz-Klimek, Cindy Woo, Raymond W. Lam and Nicola Berman
Andres M. Lozano, Peter Giacobbe, Clement Hamani, Sakina J. Rizvi, Sidney H. Kennedy, Theodore T. Kolivakis, Guy Debonnel, Abbas F. Sadikot, Raymond W. Lam, Andrew K. Howard, Magda Ilcewicz-Klimek, Christopher R. Honey and Helen S. Mayberg
Deep brain stimulation (DBS) has been recently investigated as a treatment for major depression. One of the proposed targets for this application is the subcallosal cingulate gyrus (SCG). To date, promising results after SCG DBS have been reported by a single center. In the present study the authors investigated whether these findings may be replicated at different institutions. They conducted a 3-center prospective open-label trial of SCG DBS for 12 months in patients with treatment-resistant depression.
Twenty-one patients underwent implantation of bilateral SCG electrodes. The authors examined the reduction in Hamilton Rating Scale for Depression (HRSD-17) score from baseline (RESP50).
Patients treated with SCG DBS had an RESP50 of 57% at 1 month, 48% at 6 months, and 29% at 12 months. The response rate after 12 months of DBS, however, increased to 62% when defined as a reduction in the baseline HRSD-17 of 40% or more. Reductions in depressive symptomatology were associated with amelioration in disease severity in patients who responded to surgery.
Overall, findings from this study corroborate the results of previous reports showing that outcome of SCG DBS may be replicated across centers.