title: Cognitive functioning after deep brain stimulation in subcallosal cingulate gyrus for treatment-resistant depression: an exploratory study.
abstract: Deep brain stimulation (DBS) is being investigated as a therapeutic alternative for patients with treatment-resistant depression (TRD), but its cognitive safety has been scarcely explored. The aim of this exploratory study is to evaluate cognitive function of patients before and after deep brain stimulation of the subgenual cingulate gyrus (SCG). Eight treatment-resistant depressed patients were implanted in subgenual cingulate gyrus. A neuropsychological battery was used to evaluate patients before surgery and 1-year after. A matched group of eight first-episode patients was also assessed. A MANOVA was performed for each cognitive domain and those tests showing main time effects were then correlated with depressive symptoms and with medication load. There were significant group and time effects for memory and a group effect for language. No significant interactions between groups or cognitive domains were observed. Medication load was negatively correlated with memory at time 1, and clinical change negatively correlated with memory improvement. These findings support the cognitive safety of DBS of subgenual cingulate gyrus, as cognitive function did not worsen after chronic stimulation and memory performance even improved. The results, though, should be interpreted cautiously given the small sample size and the fact that some treatment-resistant patients received electroconvulsive therapy (ECT) before implantation.
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Serra-Blasco
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Sol
authors.initials: S
authors.lastname: de Vita
authors.affiliation: Department of Psychiatry - Universidad Autónoma de Madrid, Hospital Universitario de la Princesa, Madrid, CIBERSAM, Madrid, Spain.
authors.forename: Mar Rivas
authors.initials: MR
authors.lastname: Rodríguez
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de Diego-Adeliño
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Puigdemont
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Martín-Blanco
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Rosario
authors.initials: R
authors.lastname: Pérez-Egea
authors.affiliation: Department of Neurosurgery - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalonia, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Molet
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Enric
authors.initials: E
authors.lastname: Álvarez
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Pérez
authors.affiliation: Department of Psychiatry - Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain. Electronic address: MPortella@santpau.cat.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Portella
mesh_terms: D000328:Adult; D003071:Cognition / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods*; D061218:Depressive Disorder, Treatment-Resistant / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D016896:Treatment Outcome
keywords: Chronic depression; Neuropsychiatry; Neuropsychology; Somatic therapies