Citation

Bernardo Pérez V, Daisy Chicaíza G, Alma Montoya L, Sandra Saldaña C, Cesar González C, Adriana Serrano R, Andrea Otero O. J. Neuroeuropsychiatry (Santiago, Chile) 2020; 58(4): 438-446.

Copyright

(Copyright © 2020, Society of Neurology, Neurosurgery and Psychiatry, Chile)

DOI

10.4067/S0717-92272020000400438

PMID

unavailable

Abstract

INTRODUCTION: Deep brain stimulation (DBS) has been proposed as a therapeutic alternative for Treatment-resistant depression (TRD) patients. However, there are multiple targets for neurostimulation and the optimal neuroanatomical landmark for this pathology is unknown. Nucleus accumbens (NAc) is a crucial part of the reward circuit and has been studied extensively in models of depression and anhedonia. The objective of this study was to describe our clinical experience with DBS of the NAc patients with TRD. Case series: It described the experience in four females between 17 and 41 years of age. All cases presented with a history of multiple hospitalizations and serious suicide attempts, despite having been treated with optimal pharmacological regimes, psychotherapy and ECT (Electroconvulsive therapy). Six months after the initiation of DBS, an improvement in the Hamilton Depression Scale and in the Global Assessment of Functioning Scale was observed. Anhedonia and abulia persisted after the surgery, although less severe.

CONCLUSION: DBS of NAc seems to offer favorable surgical outcomes in patients with TRD, impacting functionality and suicidal risk. © 2020 Sociedad de Neurologia Psiquiatria y Neurocirugia. All rights reserved.

Language: es

Keywords

Suicidal ideation; Deep brain stimulation; Nucleus accumbens; Treatment resistant depression