Biological Psychiatry
Volume 67, Issue 2 , Pages 110-116 , 15 January 2010

Nucleus Accumbens Deep Brain Stimulation Decreases Ratings of Depression and Anxiety in Treatment-Resistant Depression

  • Bettina H. Bewernick

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
  • ,
  • René Hurlemann

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
  • ,
  • Andreas Matusch

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
  • ,
  • Sarah Kayser

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
  • ,
  • Christiane Grubert

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
  • ,
  • Barbara Hadrysiewicz

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
  • ,
  • Nikolai Axmacher

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
    • Department of Epileptology, University Hospital, Bonn, Germany
  • ,
  • Matthias Lemke

      Affiliations

    • Department of Psychiatry, Hospital Alsterdorf, Hamburg, Germany
  • ,
  • Deirdre Cooper-Mahkorn

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
  • ,
  • Michael X. Cohen

      Affiliations

    • Department of Psychology, University of California, Davis, California
  • ,
  • Holger Brockmann

      Affiliations

    • Department of Nuclear Medicine, University Hospital, Bonn, Germany
  • ,
  • Doris Lenartz

      Affiliations

    • Department of Functional Neurosurgery, University Hospital, Cologne, Germany
  • ,
  • Volker Sturm

      Affiliations

    • Department of Functional Neurosurgery, University Hospital, Cologne, Germany
  • ,
  • Thomas E. Schlaepfer

      Affiliations

    • Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
    • Departments of Psychiatry and Mental Health, The Johns Hopkins University, Baltimore, Maryland
    • Corresponding Author InformationAddress correspondence to Thomas E. Schlaepfer, M.D., Department of Psychiatry, University Hospital, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany

Received 9 July 2009 ,Revised 3 September 2009 ,Accepted 11 September 2009.

References 

  1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602
  2. Fava M, Davidson KG. Definition and epidemiology of treatment-resistant depression. Psychiatr Clin North Am. 1996;19:179–200
  3. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. Am J Psychiatry. 2006;163:1905–1917
  4. Holtzheimer PE, Nemeroff CB. Novel targets for antidepressant therapies. Curr Psychiatry Rep. 2008;10:465–473
  5. Schlaepfer T, Lieb K. Deep brain stimulation for treatment refractory depression. Lancet. 2005;366:1420–1422
  6. Krishnan V, Nestler EJ. The molecular neurobiology of depression. Nature. 2008;455:894–902
  7. Berton O, Nestler EJ. New approaches to antidepressant drug discovery: Beyond monoamines. Nat Rev Neurosci. 2006;7:137–151
  8. Lozano AM, Mayberg HS, Giacobbe P, Hamani C, Craddock RC, Kennedy SH. Subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression. Biol Psychiatry. 2008;64:461–467
  9. Malone DA, Dougherty DD, Rezai AR, Carpenter LL, Friehs GM, Eskandar EN, et al. Deep brain stimulation of the ventral capsule/ventral striatum for treatment-resistant depression. Biol Psychiatry. 2009;65:267–275
  10. Schlaepfer TE, Cohen MX, Frick C, Kosel M, Brodesser D, Axmacher N, et al. Deep brain stimulation to reward circuitry alleviates anhedonia in refractory major depression. Neuropschopharmacology. 2008;33:368–377
  11. Gorwood P. Neurobiological mechanisms of anhedonia. Dialogues Clin Neurosci. 2008;10:291–299
  12. Epstein J, Pan H, Kocsis JH, Yang Y, Butler T, Chusid J, et al. Lack of ventral striatal response to positive stimuli in depressed versus normal subjects. Am J Psychiatry. 2006;163:1784–1790
  13. Tremblay LK, Naranjo CA, Graham SJ, Herrmann N, Mayberg HS, Hevenor S, et al. Functional neuroanatomical substrates of altered reward processing in major depressive disorder revealed by a dopaminergic probe. Arch Gen Psychiatry. 2005;62:1228–1236
  14. Synofzyk M, Schlaepfer TE. Stimulating personality: Ethical criteria for deep brain stimulation in psychiatric patients and for enhancement purposes. J Biotechnol. 2008;3:1511–1520
  15. Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967;6:278–296
  16. Rosenthal SH, Klerman GL. Endogenous features of depression in women. Can Psychiatr Assoc J. 1966;11(suppl):11–16
  17. Endicott J, Cohen J, Nee J, Fleiss J, Sarantakos S. Hamilton Depression Rating Scale (Extracted from regular and change versions of the Schedule for Affective Disorders and Schizophrenia). Arch Gen Psychiatry. 1981;38:98–103
  18. Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382–389
  19. Hamilton M. HAMA Hamilton Anxiety Scale. In:  Guy W editors. ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: National Institute of Mental Health; 1976;p. 193–198
  20. Beck A. Beck Depression Inventory: Manual. San Antonio, TX: Psychological Corporation; 1987;
  21. Rush AJ, Gullion CM, Basco MR, Jarrett RB, Trivedi MH. The Inventory of Depressive Symptomatology (IDS): Psychometric properties. Psychol Med. 1996;26:477–486
  22. Franke G. SCL-90-R. Die Symptom-CHeckliste von Derogatis (Deutsche Version). Weinheim, Germany: Beltz-Verlag; 1995;
  23. Hautzinger M. Kognitive Verhaltenstherapie bei Depressionen. München, Weinheim, Germany: Beltz; 2000;
  24. Lewinsohn PM, Graf M. Pleasant activities and depression. J Consult Clin Psychol. 1973;41:261–268
  25. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, et al. A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med. 2006;355:896–908
  26. Mayberg H. Modulating dysfunctional limbic-cortical circuits in depression: Towards development of brain-based algorithms for diagnosis and optimised treatment. Br Med Bull. 2003;65:193–207
  27. Mayberg HS, Liotti M, Brannan SK, McGinnis S, Mahurin RK, Jerabek PA, et al. Reciprocal limbic-cortical function and negative mood: Converging PET findings in depression and normal sadness. Am J Psychiatry. 1999;156:675–682
  28. Ressler KJ, Mayberg HS. Targeting abnormal neural circuits in mood and anxiety disorders: From the laboratory to the clinic. Nat Neurosci. 2007;10:1116–1124
  29. Mayberg H, Lozano A, Voon V, McNeely H, Seminowicz D, Hamani C, et al. Deep brain stimulation for treatment-resistant depression. Neuron. 2005;45:651–660
  30. Krishnan V, Han MH, Graham DL, Berton O, Renthal W, Russo SJ, et al. Molecular adaptations underlying susceptibility and resistance to social defeat in brain reward regions. Cell. 2007;131:391–404
  31. Berton O, McClung CA, DiLeone RJ, Krishnan V, Renthal W, Russo SJ, et al. Essential role of BDNF in the mesolimbic dopamine pathway in social defeat stress. Science. 2006;311:864–868
  32. Cohen MX, Axmacher N, Lenartz D, Elger CE, Sturm V, Schlaepfer TE. Neuroelectric signatures of reward learning and decision-making in the human nucleus accumbens. Neuropsychopharmacology. 2009;34:1649–1658
  33. Gutman DA, Holtzheimer PE, Behrens TE, Johansen-Berg H, Mayberg HS. A tractography analysis of two deep brain stimulation white matter targets for depression. Biol Psychiatry. 2009;65:276–282
  34. Cohen MX, Axmacher N, Lenartz D, Elger CE, Sturm V, Schlaepfer TE. Good vibrations: Cross-frequency coupling in the human nucleus accumbens during reward processing. J Cogn Neurosci. 2009;21:875–879
  35. Nitschke JB, Sarinopoulos I, Oathes DJ, Johnstone T, Whalen PJ, Davidson RJ, et al. Anticipatory activation in the amygdala and anterior cingulate in generalized anxiety disorder and prediction of treatment response. Am J Psychiatry. 2009;166:302–310
  36. Schatzberg AF, Kraemer HC. Use of placebo control groups in evaluating efficacy of treatment of unipolar major depression. Biol Psychiatry. 2000;47:736–744
  37. Rush AJ, Sackeim HA, Marangell LB, George MS, Brannan SK, Davis SM, et al. Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: A naturalistic study. Biol Psychiatry. 2005;58:355–363
  38. Sackeim HA. The definition and meaning of treatment-resistant depression. J Clin Psychiatry. 2001;62(suppl 16):10–17

PII: S0006-3223(09)01094-4

doi: 10.1016/j.biopsych.2009.09.013

Biological Psychiatry
Volume 67, Issue 2 , Pages 110-116 , 15 January 2010