Subcallosal cingulate deep brain stimulation for treatment-resistant depression: a multisite, randomised, sham-controlled trial

Holtzheimer, Paul E.; Husain, Mustafa M.; Lisanby, Sarah H.; Taylor, Stephan F.; Whitworth, Louis A.; McClintock, Shawn M.; Slavin, Konstantin V.; Berman, Joshua A.; McKhann, Guy M.; Patil, Parag G.; Rittberg, Barry R.; Abosch, Aviva; Pandurangi, Anand K.; Holloway, Kathryn L.; Lam, Raymond W.; Honey, Christopher R.; Neimat, Joseph S.; Henderson, Jaimie M.; DeBattista, Charles; Rothschild, Anthony J.; Pilitsis, Julie G.; Espinoza, Randall; Petrides, Georgios; Mogilner, Alon Y.; Matthews, Keith; Peichel, De Lea; Gross, Robert E.; Hamani, Clement; Lozano, Andrés M.; Mayberg, Helen S.

doi:10.1016/s2215-0366(17)30371-1

Cited by 417 publications

(344 citation statements)

References 42 publications

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“…In 2017, the 6 month, double-blind, sham-controlled BROADEN trial reported no statistically significant antidepressant effects of subcallosal cingulate DBS in treatment-resistant depression1. Only individuals who had unsuccessful trials of pharmacotherapy, psychotherapy and electroconvulsive therapy were eligible to participate.…”

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confidence: 99%

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“…While the results of the Reclaim trial had already been published29 at the time of this workshop, the BROADEN data were still under review at that time and therefore were not fully available to workshop participants. BROADEN results were published during the review of this manuscript34 and are included here for the sake of completeness and for the relevance they bear to this discussion.…”

Section: Current State Of Knowledgementioning

confidence: 99%

“…BROADEN was a randomised, double-blind, sham-controlled, multisite, trial of SGC DBS for depression sponsored by St. Jude Medical (now Abbott) 34. All subjects were implanted and then randomised (double blind, 2:1 active:sham) after 2 weeks to active or sham stimulation for 6 months.…”

Section: Current State Of Knowledgementioning

confidence: 99%

“…In addition, both trials placed strict limitations on medication changes and stimulation adjustments. For example, Reclaim did not permit monopolar stimulation29 and BROADEN did not permit adjustment of frequency or pulse width 34. The higher response rate in the open-label follow-up period in BROADEN, during which stimulation adjustments were unconstrained, suggests that unaccessed regions of the parameter space may have been important.…”

Section: Current State Of Knowledgementioning

confidence: 99%

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Charting the road forward in psychiatric neurosurgery: proceedings of the 2016 American Society for Stereotactic and Functional Neurosurgery workshop on neuromodulation for psychiatric disorders

Bari

Mikell

Abosch

et al. 2018

J Neurol Neurosurg Psychiatry

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“…Moreover, deep brain stimulation (DBS) is a favored approach; however, its application is at the trial stage, and it remains unknown which is the best stimulation target for depression. Subcallosal cingulate DBS and anterior limb of the internal capsule (ALIC) DBS may be promising for pain and depression relief; however, a recent randomized controlled trial on subcallosal cingulate DBS failed to show its superior effectiveness for depression [6]. ALIC DBS was effective for depression [7]; however, it still lacks solid evidences to support its efficacy for treating pain, and a recent randomized controlled trial showed its negative response to poststroke pain syndrome [8], thus, the efficacy of ALIC DBS for PLP remains uncertain and requires more specific trials for its validation.…”

Section: Scs Combined With Anteriormentioning

confidence: 99%

Spinal Cord Stimulation Combined with Anterior Cingulotomy to Manage Refractory Phantom Limb Pain

Deng

Zhan

et al. 2018

Stereotact Funct Neurosurg

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Background: Phantom limb pain (PLP) is an intractable and debilitating disease without satisfactory treatment options presently available. Central reorganization, peripheral changes, and psychiatric factors contribute to its development; thus, a neuropsychiatry-orientated combined therapy could be promising. Objectives: We used a combined strategy with the aims of demonstrating its therapeutic outcomes on PLP. Methods: The patient initially received spinal cord stimulation (SCS) implantation and then anterior cingulotomy (ACING) 2 years later. We administered the Hamilton Depression Scale-24, Hamilton Anxiety Scale, Pain Rating Index, Numerical Pain Rating Scale, and the Short Form (36) Health Survey to assess its outcomes at 5 time points, namely the time before performing SCS implantation, 1 year and 2 years after SCS implantation, and 1 year and 2 years after SCS combined with ACING. Results: Excellent pain relief and significant improvement in depression symptoms were observed in this patient with PLP who underwent SCS combined with ACING. Conclusions: This report suggests that SCS combined with ACING is efficacious for PLP. However, further studies are warranted.

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Subcallosal cingulate deep brain stimulation for treatment-resistant depression: a multisite, randomised, sham-controlled trial

Cited by 417 publications

References 42 publications

Continued access to investigational brain implants

Continued access to investigational brain implants

Charting the road forward in psychiatric neurosurgery: proceedings of the 2016 American Society for Stereotactic and Functional Neurosurgery workshop on neuromodulation for psychiatric disorders

Spinal Cord Stimulation Combined with Anterior Cingulotomy to Manage Refractory Phantom Limb Pain

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