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000008507 0247_ $$2DOI$$a10.1016/j.biopsych.2009.09.013
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000008507 084__ $$2WoS$$aNeurosciences
000008507 084__ $$2WoS$$aPsychiatry
000008507 1001_ $$0P:(DE-HGF)0$$aBewernick, B.H.$$b0
000008507 245__ $$aNucleus Accumbens Deep Brain Stimulation Decreases Ratings of Depression and Anxiety in Treatment-Resistant Depression
000008507 260__ $$aAmsterdam [u.a.]$$bElsevier Science$$c2010
000008507 300__ $$a110 - 116
000008507 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article
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000008507 440_0 $$011361$$aBiological Psychiatry$$v67$$x0006-3223$$y2
000008507 500__ $$aThis investigation-initiated study was funded in part (deep brain stimulation device, battery exchange, medical costs, limited support for study nurse) by a Grant of Medtronic, Inc. to Drs Schlaepfer and Strum. Dr. Hurlemann is supported by a Starting Independent Researcher Grant provided by the Ministry of Innovation, Science, Research and Technology of the State of North Rhine-Westphalia (MIWFT).
000008507 520__ $$aWhile most patients with depression respond to combinations of pharmacotherapy, psychotherapy, and electroconvulsive therapy (ECT), there are patients requiring other treatments. Deep brain stimulation (DBS) allows modulation of brain regions that are dysfunctional in depression. Since anhedonia is a feature of depression and there is evidence of dysfunction of the reward system, DBS to the nucleus accumbens (NAcc) might be promising.Ten patients suffering from very resistant forms of depression (treatment-resistant depression [TRD]), not responding to pharmacotherapy, psychotherapy, or ECT, were implanted with bilateral DBS electrodes in the NAcc. The mean (+/-SD) length of the current episode was 10.8 (+/-7.5) years; the number of past treatment courses was 20.8 (+/-8.4); and the mean Hamilton Depression Rating Scale (HDRS) was 32.5 (+/-5.3).Twelve months following initiation of DBS treatment, five patients reached 50% reduction of the HDRS (responders, HDRS = 15.4 [+/-2.8]). The number of hedonic activities increased significantly. Interestingly, ratings of anxiety (Hamilton Anxiety Scale) were reduced in the whole group but more pronounced in the responders. The [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography data revealed that NAcc-DBS decreased metabolism in the subgenual cingulate and in prefrontal regions including orbital prefrontal cortex. A volume of interest analysis comparing responders and nonresponders identified metabolic decreases in the amygdala.We demonstrate antidepressant and antianhedonic effects of DBS to NAcc in patients suffering from TRD. In contrast to other DBS depression studies, there was also an antianxiety effect. These effects are correlated with localized metabolic changes.
000008507 536__ $$0G:(DE-Juel1)FUEK409$$2G:(DE-HGF)$$aFunktion und Dysfunktion des Nervensystems (FUEK409)$$cFUEK409$$x0
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000008507 650_2 $$2MeSH$$aAdult
000008507 650_2 $$2MeSH$$aAged
000008507 650_2 $$2MeSH$$aAmygdala: radionuclide imaging
000008507 650_2 $$2MeSH$$aBrain Mapping
000008507 650_2 $$2MeSH$$aDeep Brain Stimulation: methods
000008507 650_2 $$2MeSH$$aDepression: pathology
000008507 650_2 $$2MeSH$$aDepression: physiopathology
000008507 650_2 $$2MeSH$$aDepression: radionuclide imaging
000008507 650_2 $$2MeSH$$aDepression: therapy
000008507 650_2 $$2MeSH$$aFemale
000008507 650_2 $$2MeSH$$aFluorodeoxyglucose F18: diagnostic use
000008507 650_2 $$2MeSH$$aGyrus Cinguli: radionuclide imaging
000008507 650_2 $$2MeSH$$aHumans
000008507 650_2 $$2MeSH$$aMale
000008507 650_2 $$2MeSH$$aMiddle Aged
000008507 650_2 $$2MeSH$$aNeuropsychological Tests
000008507 650_2 $$2MeSH$$aNucleus Accumbens: physiology
000008507 650_2 $$2MeSH$$aNucleus Accumbens: radionuclide imaging
000008507 650_2 $$2MeSH$$aPositron-Emission Tomography: methods
000008507 650_2 $$2MeSH$$aPrefrontal Cortex: physiopathology
000008507 650_2 $$2MeSH$$aPrefrontal Cortex: radionuclide imaging
000008507 650_2 $$2MeSH$$aPsychiatric Status Rating Scales
000008507 650_2 $$2MeSH$$aTreatment Outcome
000008507 650_7 $$063503-12-8$$2NLM Chemicals$$aFluorodeoxyglucose F18
000008507 650_7 $$2WoSType$$aJ
000008507 65320 $$2Author$$aDeep brain stimulation
000008507 65320 $$2Author$$afunctional neuroimaging
000008507 65320 $$2Author$$amajor depression
000008507 65320 $$2Author$$aneuromodulation
000008507 65320 $$2Author$$anucleus accumbens
000008507 65320 $$2Author$$atreatment resistance
000008507 7001_ $$0P:(DE-HGF)0$$aHurlemann, R.$$b1
000008507 7001_ $$0P:(DE-Juel1)138474$$aMatusch, A.$$b2$$uFZJ
000008507 7001_ $$0P:(DE-HGF)0$$aKayser, S.$$b3
000008507 7001_ $$0P:(DE-HGF)0$$aGrubert, C.$$b4
000008507 7001_ $$0P:(DE-HGF)0$$aHadrysiewicz, B.$$b5
000008507 7001_ $$0P:(DE-HGF)0$$aAxmacher, N.$$b6
000008507 7001_ $$0P:(DE-HGF)0$$aLemke, M.$$b7
000008507 7001_ $$0P:(DE-HGF)0$$aCooper-Mahkorn, D.$$b8
000008507 7001_ $$0P:(DE-HGF)0$$aCohen, M.X.$$b9
000008507 7001_ $$0P:(DE-HGF)0$$aBrockmann, H.$$b10
000008507 7001_ $$0P:(DE-HGF)0$$aLenartz, D.$$b11
000008507 7001_ $$0P:(DE-HGF)0$$aSturm, V.$$b12
000008507 7001_ $$0P:(DE-HGF)0$$aSchlaepfer, T.E.$$b13
000008507 773__ $$0PERI:(DE-600)1499907-9$$a10.1016/j.biopsych.2009.09.013$$gVol. 67, p. 110 - 116$$p110 - 116$$q67<110 - 116$$tBiological psychiatry$$v67$$x0006-3223$$y2010
000008507 8567_ $$uhttp://dx.doi.org/10.1016/j.biopsych.2009.09.013
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