title: Deep brain stimulation for treatment-resistant depression.
abstract: BACKGROUND
  Major depressive disorder is a common and disabling illness and is the leading cause of disability worldwide. Despite aggressive medical, behavioral, and electroconvulsive therapies, a significant number of patients remain refractory to treatment. Deep brain stimulation (DBS) has proven efficacy in neurobehavioral disorders and, in a general sense, works by modulation of corticostriatopallidothalamocortical circuits implicated in these disorders.
  
  
  METHODS
  Current data, treatment rationales, and future directions are presented.
  
  
  RESULTS
  The two targets most commonly used for DBS in treatment-resistant depression are the subgenual cingulate gyrus and the ventral capsule/ventral striatum. Data on DBS of these regions are preliminary, with promise shown in early studies.
  
  
  CONCLUSIONS
  Early work suggests DBS may become a therapeutic option in treatment-resistant depression. Further study is justified given the immense burden of disease.
authors.affiliation: Department of Neurological Surgery, Center for Neuromodulation, Ohio State University, Columbus, Ohio, USA; Orange County Neurosurgical Associates, Mission Viejo, California, USA. Electronic address: alextaghva@yahoo.com.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Taghva
authors.forename: Donald A
authors.initials: DA
authors.lastname: Malone
authors.forename: Ali R
authors.initials: AR
authors.lastname: Rezai
mesh_terms: D003342:Corpus Striatum / Q000502:physiology / Q000601:surgery; D046690:Deep Brain Stimulation / Q000379:methods*; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology* / Q000628:therapy*; D004351:Drug Resistance; D006179:Gyrus Cinguli / Q000502:physiology / Q000601:surgery; D049673:History, 20th Century; D006801:Humans; D020772:Internal Capsule / Q000502:physiology / Q000601:surgery; D009434:Neural Pathways / Q000473:pathology / Q000601:surgery; D009493:Neurosurgery / Q000266:history; D009714:Nucleus Accumbens / Q000502:physiology / Q000601:surgery; D013238:Stereotaxic Techniques
keywords: ALIC; Anterior limb of internal capsule; CSPTC; Corticostriatopallidothalamocortical; DBS; Deep brain stimulation; Depression; MDD; Major depressive disorder; NAcc; Neuromodulation; Nucleus accumbens; OCD; Obsessive-compulsive disorder; SGC; Subgenual cingulate gyrus; TRD; Treatment-resistant depression; VC; VS; Ventral capsule; Ventral striatum