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

TOKARZEWSKA, Agata, ORCZYK, Jakub, OŁOWNIA, Aleksandra & MAŁYSZEK, Maciej. Use of deep brain stimulation for treatment-resistant depression - review of main stimulation targets. Journal of Education, Health and Sport. 2023;13(5):18-26. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2023.13.05.002

https://apcz.umk.pl/JEHS/article/view/42665

https://zenodo.org/record/7700283

The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343.

Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences).

Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159.

Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu).

© The Authors 2023;

This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland

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Received: 19.02.2023. Revised: 22.02.2023. Accepted: 04.03.2023. Published: 05.03.2023.

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

Agata Tokarzewska

Uniwersytet Medyczny w Lublinie

 https://orcid.org/0000-0001-9539-1697

Jakub Orczyk

Uniwersytet Medyczny w Lublinie

 https://orcid.org/0000-0002-4201-545X

Aleksandra Ołownia

Uniwersytet Medyczny w Lublinie

 https://orcid.org/0000-0001-6164-6639

Maciej Małyszek

Uniwersytet Medyczny w Lublinie

 https://orcid.org/0000-0002-9338-3623

Abstract

Deep brain stimulation (DBS) is an innovative method using neuromodulation in treatment of various diseases, most commonly used in Parkinson’s disease, tremor and dystonia. Due to method’s minimally invasive nature and very low incidence of severe adverse effects, the research upon its use in other indications is conducted. Treatment-resistant depression (TRD) is one of these emerging indications. Currently available data regarding the matter concentrate mainly of electrode placement within seven particular structures of the brain: the subgenual anterior cingulate cortex, the ventral capsule/ventral striatum, the lateral habenula, the nucleus accumbens, the inferior thalamic peduncle, the bed nucleus of the stria terminalis and the medial forebrain bundle. It is yet to be determined which stimulation targets bring the most optimal effect. Published clinical trials give basis to theorize that stimulation of each DBS target results in different neurotransmitter modulation. Antidepressant effects vary also depending on stimulation parameters and overall duration. The aim of this review is to compare various targets for stimulation and underlying physiological mechanisms in therapy of TRD. It is needed to keep in mind that there is still high demand on well-designed, randomized, double-blind trials on bigger groups of patients in order to exclude potential inconsistency between results of clinical research.

Key words: Deep brain stimulation, Treatment-resistant depressive disorder, Major depressive disorder