title: Cognitive outcome after ventral capsule/ventral striatum stimulation for treatment-resistant major depression.
abstract: BACKGROUND
  We report the neuropsychological outcome of 25 patients with treatment-resistant major depressive disorder (TRD) who participated in an Institutional Review Board (IRB)-approved randomised double-blind trial comparing active to sham deep brain stimulation (DBS) in the anterior limb of the ventral capsule/ventral striatum (VC/VS).
  
  
  METHODS
  Participants were randomised to active (n=12) versus sham (n=13) DBS for 16 weeks. Data were analysed at the individual and group levels. Group differences were analysed using repeated measures ANOVAs. Relationships between depression severity and cognition were examined using partial correlations. The false discovery rate method controlled for multiple analyses.
  
  
  RESULTS
  No significant interactions comparing active versus sham stimulation over time were evident. Change in depression was unrelated to change in neuropsychological measures. Twenty patients declined by ≥1 SD on at least one measure (41.3% of declines occurred in active group participants; 63.0% in older participants regardless of stimulation status). Twenty-two patients exhibited improvements >1 SD on neuropsychological measures (47.7% in the active group; 63.1% in younger participants).
  
  
  CONCLUSIONS
  These data suggest that VC/VS DBS in patients with TRD does not significantly affect neuropsychological function. Age at surgery, regardless of stimulation status, may be related to cognitive outcome at the individual patient level.
  
  
  BACKGROUND
  NCT00837486; Results.
authors.affiliation: Department of Psychiatry and Psychology, P57, Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Kubu
authors.affiliation: Medtronic, Minneapolis, Minnesota, USA.
authors.forename: Tim
authors.initials: T
authors.lastname: Brelje
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Meryl A
authors.initials: MA
authors.lastname: Butters
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Thilo
authors.initials: T
authors.lastname: Deckersbach
authors.affiliation: Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, Rhode Island, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Malloy
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Moberg
authors.affiliation: Department of Clinical Neuropsychology, Center for Neuromodulation, Barrow Neurological Institute, Phoenix, Arizona, USA.
authors.forename: Alexander I
authors.initials: AI
authors.lastname: Tröster
authors.affiliation: Medtronic, Minneapolis, Minnesota, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Williamson
authors.affiliation: Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Baltuch
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Mahendra T
authors.initials: MT
authors.lastname: Bhati
authors.affiliation: Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, Rhode Island, USA.
authors.forename: Linda L
authors.initials: LL
authors.lastname: Carpenter
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Darin D
authors.initials: DD
authors.lastname: Dougherty
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Howland
authors.affiliation: Department of Neurological Surgery, Ohio State University, Columbus, Ohio, USA.
authors.forename: Ali R
authors.initials: AR
authors.lastname: Rezai
authors.affiliation: Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Donald A
authors.initials: DA
authors.lastname: Malone
mesh_terms: D003071:Cognition / Q000502:physiology*; D046690:Deep Brain Stimulation; D061218:Depressive Disorder, Treatment-Resistant / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D066328:Ventral Striatum
keywords: DEPRESSION; NEUROPSYCHOLOGY; NEUROSURGERY