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Correspondence| Volume 85, ISSUE 6, e23-e24, March 15, 2019

Discontinuation of Superolateral Medial Forebrain Bundle Deep Brain Stimulation for Treatment-Resistant Depression Leads to Critical Relapse

Published:September 22, 2018DOI:https://doi.org/10.1016/j.biopsych.2018.07.025
Discontinuation of Superolateral Medial Forebrain Bundle Deep Brain Stimulation for Treatment-Resistant Depression Leads to Critical Relapse
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      Deep brain stimulation (DBS) is investigated as a possible therapy for treatment-resistant depression (TRD) (
      • Lozano A.M.
      • Mayberg H.S.
      • Giacobbe P.
      • Hamani C.
      • Craddock R.C.
      • Kennedy S.H.
      Subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression.
      Biol Psychiatry. 2008; 64: 461-467
      ,
      • Mayberg H.S.
      • Lozano A.M.
      • Voon V.
      • McNeely H.E.
      • Seminowicz D.
      • Hamani C.
      • et al.
      Deep brain stimulation for treatment-resistant depression.
      Neuron. 2005; 45: 651-660
      ,
      • Bewernick B.H.
      • Hurlemann R.
      • Matusch A.
      • Kayser S.
      • Grubert C.
      • Hadrysiewicz B.
      • et al.
      Nucleus accumbens deep brain stimulation decreases ratings of depression and anxiety in treatment-resistant depression.
      Biol Psychiatry. 2010; 67: 110-116
      ,
      • Kennedy S.H.
      • Giacobbe P.
      • Rizvi S.J.
      • Placenza F.M.
      • Nishikawa Y.
      • Mayberg H.S.
      • et al.
      Deep brain stimulation for treatment-resistant depression: Follow-up after 3 to 6 years.
      Am J Psychiatry. 2011; 168: 502-510
      ,
      • Schlaepfer T.E.
      • Bewernick B.H.
      • Kayser S.
      • Mädler B.
      • Coenen V.A.
      Rapid effects of deep brain stimulation for treatment-resistant major depression.
      Biol Psychiatry. 2013; 73: 1204-1212
      ,
      • Puigdemont D.
      • Pérez-Egea R.
      • Portella M.J.
      • Molet J.
      • de Diego-Adeliño J.
      • Gironell A.
      • et al.
      Deep brain stimulation of the subcallosal cingulate gyrus: Further evidence in treatment-resistant major depression.
      Int J Neuropsychopharmacol. 2012; 15: 121-133
      ,
      • Bewernick B.H.
      • Kayser S.
      • Sturm V.
      • Schlaepfer T.E.
      Long-term effects of nucleus accumbens deep brain stimulation in treatment-resistant depression: Evidence for sustained efficacy.
      Neuropsychopharmacology. 2012; 37: 1975-1985
      ). DBS of the superolateral medial forebrain bundle (slMFB) is associated with rapid and sustained antidepressant effects (
      • Bewernick B.H.
      • Kayser S.
      • Gippert S.M.
      • Switala C.
      • Coenen V.A.
      • Schlaepfer T.E.
      Deep brain stimulation to the medial forebrain bundle for depression-long-term outcomes and a novel data analysis strategy.
      Brain Stimul. 2017; 10: 664-671
      ). Little is known about the effect of DBS cessation after long-term treatment in psychiatric disorders. Previous clinical studies showed aggravation of depression after DBS discontinuation in TRD. Prediscontinuation level could be recaptured following different timelines after reinitiation of stimulation (
      • Mayberg H.S.
      • Lozano A.M.
      • Voon V.
      • McNeely H.E.
      • Seminowicz D.
      • Hamani C.
      • et al.
      Deep brain stimulation for treatment-resistant depression.
      Neuron. 2005; 45: 651-660
      ,
      • Holtzheimer P.E.
      • Kelley M.E.
      • Gross R.E.
      • Filkowski M.M.
      • Garlow S.J.
      • Barrocas A.
      • et al.
      Subcallosal cingulate deep brain stimulation for treatment-resistant unipolar and bipolar depression.
      Arch Gen Psychiatry. 2012; 69: 150-158
      ,
      • Bergfeld I.O.
      • Mantione M.
      • Hoogendoorn M.L.
      • Ruhé H.G.
      • Notten P.
      • van Laarhoven J.
      • et al.
      Deep brain stimulation of the ventral anterior limb of the internal capsule for treatment-resistant depression: A randomized clinical trial.
      JAMA Psychiatry. 2016; 73: 456-464
      ).
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      References

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        • Craddock R.C.
        • Kennedy S.H.
        Subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression.
        Biol Psychiatry. 2008; 64: 461-467
        View in Article
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        • McNeely H.E.
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        Deep brain stimulation for treatment-resistant depression.
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        Nucleus accumbens deep brain stimulation decreases ratings of depression and anxiety in treatment-resistant depression.
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        View in Article
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        • Giacobbe P.
        • Rizvi S.J.
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        • et al.
        Deep brain stimulation for treatment-resistant depression: Follow-up after 3 to 6 years.
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        View in Article
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        View in Article
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        Deep brain stimulation of the subcallosal cingulate gyrus: Further evidence in treatment-resistant major depression.
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        View in Article
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      Article info

      Publication history

      Published online: September 22, 2018

      Identification

      DOI: https://doi.org/10.1016/j.biopsych.2018.07.025

      Copyright

      © 2018 Society of Biological Psychiatry.

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