A decade of progress in deep brain stimulation of the subcallosal cingulate for the treatment of depression

Sharafuddin Khairuddin, Fung Yin Ngo, Wei Ling Lim, Luca Aquili, Naveed Ahmed Khan, Man-Lung Fung, Ying-Shing Chan, Yasin Temel, Lee Wei Lim

Research output: Contribution to journalArticle

Abstract

Major depression contributes significantly to the global disability burden. Since the first clinical study of deep brain stimulation (DBS), over 446 patients with depression have now undergone this neuromodulation therapy, and 29 animal studies have investigated the efficacy of subgenual cingulate DBS for depression. In this review, we aim to provide a comprehensive overview of the progress of DBS of the subcallosal cingulate in humans and the medial prefrontal cortex, its rodent homolog. For preclinical animal studies, we discuss the various antidepressant-like behaviors induced by medial prefrontal cortex DBS and examine the possible mechanisms including neuroplasticity-dependent/independent cellular and molecular changes. Interestingly, the response rate of subcallosal cingulate Deep brain stimulation marks a milestone in the treatment of depression. DBS achieved response and remission rates of 64–76% and 37–63%, respectively, from clinical studies monitoring patients from 6–24 months. Although some studies showed its stimulation efficacy was limited, it still holds great promise as a therapy for patients with treatment-resistant depression. Overall, further research is still needed, including more credible clinical research, preclinical mechanistic studies, precise selection of patients, and customized electrical stimulation paradigms.
Original languageEnglish
Article number3260
Pages (from-to)1-49
Number of pages49
JournalJournal of Clinical Medicine
Volume9
Issue number10
DOIs
Publication statusPublished - 12 Oct 2020

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    Khairuddin, S., Ngo, F. Y., Lim, W. L., Aquili, L., Khan, N. A., Fung, M-L., Chan, Y-S., Temel, Y., & Lim, L. W. (2020). A decade of progress in deep brain stimulation of the subcallosal cingulate for the treatment of depression. Journal of Clinical Medicine, 9(10), 1-49. [3260]. https://doi.org/10.3390/jcm9103260