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Rapid Antidepressant Effects of Deep Brain Stimulation and Their Relation to Surgical Protocol

      Deep brain stimulation (DBS) of the subcallosal cingulate has been tested in a series of studies with repeated evidence of sustained long-term effects but with a variable time course of symptom improvement across cohorts. Several randomized controlled trials of different DBS brain targets did not show differences between active and sham stimulation, and a possible cause of failure may have been the prolonged time until clinical response was seen (
      • Dougherty D.D.
      • Rezai A.R.
      • Carpenter L.L.
      • Howland R.H.
      • Bhati M.T.
      • O'Reardon J.P.
      • et al.
      A randomized sham-controlled trial of deep brain stimulation of the ventral capsule/ventral striatum for chronic treatment-resistant depression.
      ,
      • Holtzheimer P.E.
      • Husain M.M.
      • Lisanby S.H.
      • Taylor S.F.
      • Whitworth L.A.
      • McClintock S.
      • et al.
      Subcallosal cingulate deep brain stimulation for treatment-resistant depression: A multisite, randomised, sham-controlled trial.
      ,
      • Coenen V.A.
      • Bewernick B.H.
      • Kayser S.
      • Kilian H.
      • Bostrom J.
      • Greschus S.
      • et al.
      Superolateral medial forebrain bundle deep brain stimulation in major depression: A gateway trial.
      ).
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