title: The nucleus accumbens: a target for deep brain stimulation in resistant major depressive disorder.
abstract: OBJECTIVE
  This review aimed to investigate the therapeutic potential of Deep Brain Stimulation (DBS) for treating resistant Major Depressive Disorder (MDD). We explored the role of Nucleus accumbens (Nac) as a target for treatment.
  
  
  METHODS
  We made a systematic review of all studies examining the mechanisms of action of high frequency brain stimulation and the pathophysiology of MDD. We also reported all the studies exploring the therapeutic potential of DBS in MDD.
  
  
  RESULTS
  As a central relay-structure, the Nac seems to play a central role in MDD symptomatology. We investigated its role as a primary target for DBS in depressed patients. Anatomically the Nac is at the centre of the interactions between dopaminergic, serotoninergic and glutamatergic systems. Functionally, the Nac is involved in both normal and abnormal reward processes and in anhedonia and loss of motivation. Due to its central location between the emotional system, the cognitive system and motor control system, the Nac seems to have a central role in mood and feeling regulation.
  
  
  CONCLUSIONS
  According to encouraging recent studies, DBS seems to be a promising technique in resistant MDD treatment.
authors.affiliation: Academic Department of Adult Psychiatry, Guillaume Régnier Hospital, EA 4712 35000, Rennes, France.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Nauczyciel
authors.affiliation: Lyon Neuroscience Research Center INSERM U1028 - CNRS UMR 5292 Dynamics and Brain Cognition, 69675, Bron, France.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Robic
authors.affiliation: Rennes University Hospital Centre Research Unit EA 4712 Behavior and Basal Ganglia, 35000, Rennes, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Dondaine
authors.affiliation: Rennes University Hospital Centre Research Unit EA 4712 Behavior and Basal Ganglia, 35000, Rennes, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Verin
authors.affiliation: Academic Department of Adult Psychiatry, Guillaume Régnier Hospital, EA 4712 35000, Rennes, France ; Rennes University Hospital Centre Research Unit EA 4712 Behavior and Basal Ganglia, 35000, Rennes, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Robert
authors.affiliation: Academic Department of Adult Psychiatry, Guillaume Régnier Hospital, EA 4712 35000, Rennes, France ; Rennes University Hospital Centre Research Unit EA 4712 Behavior and Basal Ganglia, 35000, Rennes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Drapier
authors.affiliation: Academic Department of Adult Psychiatry, Guillaume Régnier Hospital, EA 4712 35000, Rennes, France ; Rennes University Hospital Centre Research Unit EA 4712 Behavior and Basal Ganglia, 35000, Rennes, France.
authors.forename: Florian
authors.initials: F
authors.lastname: Naudet
authors.affiliation: Academic Department of Adult Psychiatry, Guillaume Régnier Hospital, EA 4712 35000, Rennes, France ; Rennes University Hospital Centre Research Unit EA 4712 Behavior and Basal Ganglia, 35000, Rennes, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Millet
keywords: Deep brain stimulation; Dopamine; Major depressive disorder; Nucleus accumbens