Asymmetrical contribution of brain structures to treatment-resistant depression as illustrated by effects of right subgenual cingulum stimulation.
Major depressive disorder is one of the most common psychiatric disorders, with a worldwide lifetime prevalence rate of 10%-20% in women and a slightly lower rate in men. While many patients are successfully treated using established therapeutic strategies, a significant percentage of patients fail to respond. This report describes the successful recovery of a previously treatment-resistant patient following right unilateral deep brain stimulation of Brodmann's area 25. Current therapeutic approaches to treatment-resistant patients are reviewed in the context of this case with an emphasis on the role of the right and left hemispheres in mediating disease pathogenesis and clinical recovery.
Guinjoan
Salvador M
SM
FLENI, Cognitive Neurology & Neuropsychiatry, Montañeses 2325 8th floor, C1428AQK Buenos Aires, Argentina. sguinjoan@fleni.org.ar
Mayberg
Helen S
HS
Costanzo
Elsa Y
EY
Fahrer
Rodolfo D
RD
Tenca
Eduardo
E
Antico
Julio
J
Cerquetti
Daniel
D
Smyth
Elisa
E
Leiguarda
Ramón C
RC
Nemeroff
Charles B
CB
D001921:Brain / Q000503:physiopathology*; D046690:Deep Brain Stimulation / Q000379:methods*; D003865:Major Depressive Disorder / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome