Deep Brain Stimulation of the Ventral Anterior Limb of the Internal Capsule for Treatment-Resistant Depression
| Autor: | Ieke Visser, Peter Notten, Bart de Kwaasteniet, Aart H. Schene, Rick Schuurman, Mariska Mantione, Guus N. Beute, Ferdinand Horst, Henricus G. Ruhé, Mechteld L.C. Hoogendoorn, Isidoor O. Bergfeld, Pepijn van den Munckhof, Jan van Laarhoven, Martijn Figee, Damiaan Denys |
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| Přispěvatelé: | ANS - Compulsivity, Impulsivity & Attention, Other departments, Adult Psychiatry, Neurosurgery, Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Netherlands Institute for Neuroscience (NIN) |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Deep brain stimulation Deep Brain Stimulation medicine.medical_treatment CAPSULE/VENTRAL STRIATUM NUCLEUS-ACCUMBENS Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13] Placebo law.invention Depressive Disorder Treatment-Resistant 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial Internal Capsule law medicine Humans Psychiatry SCALE Depression (differential diagnoses) Netherlands OUTCOMES Depressive Disorder Major Cross-Over Studies Intention-to-treat analysis PATHWAYS Hamilton Rating Scale for Depression TRACTOGRAPHY OBSESSIVE-COMPULSIVE DISORDER MAJOR DEPRESSION Middle Aged medicine.disease Crossover study Electrodes Implanted Intention to Treat Analysis 030227 psychiatry Psychiatry and Mental health Treatment Outcome Editorial Anesthesia REACH Female Psychology Treatment-resistant depression 030217 neurology & neurosurgery |
| Zdroj: | JAMA Psychiatry, 73, 5, pp. 456-64 JAMA Psychiatry, 73, 456-64 JAMA psychiatry, 73(5), 456-464. American Medical Association Jama psychiatry, 73(5), 456-464. AMER MEDICAL ASSOC JAMA Psychiatry, 73(5), 456-64. American Medical Association |
| ISSN: | 2168-622X 2168-6238 |
| DOI: | 10.1001/jamapsychiatry.2016.0152 |
| Popis: | Item does not contain fulltext IMPORTANCE: Patients with treatment-resistant depression (TRD) do not respond sufficiently to several consecutive treatments for major depressive disorder. Deep brain stimulation (DBS) is a promising treatment for these patients, but presently placebo effects cannot be ruled out. OBJECTIVE: To assess the efficacy of DBS of the ventral anterior limb of the internal capsule (vALIC), controlling for placebo effects with active and sham stimulation phases. DESIGN, SETTING, AND PARTICIPANTS: Twenty-five patients with TRD from 2 hospitals in the Netherlands were enrolled between March 22, 2010, and May 8, 2014. Patients first entered a 52-week open-label trial during which they received bilateral implants of 4 contact electrodes followed by optimization of DBS until a stable response was achieved. A randomized, double-blind, 12-week crossover phase was then conducted with patients receiving active treatment followed by sham or vice versa. Response and nonresponse to treatment were determined using intention-to-treat analyses. INTERVENTIONS: Deep brain stimulation targeted to the vALIC. MAIN OUTCOMES AND MEASURES: The change in the investigator-rated score of the 17-item Hamilton Depression Rating Scale (HAM-D-17) was the main outcome used in analysis of the optimization phase. The primary outcome of the crossover phase was the difference in the HAM-D-17 scores between active and sham DBS. The score range of this tool is 0 to 52, with higher scores representing more severe symptoms. Patients were classified as responders to treatment (>/=50% decrease of the HAM-D-17 score compared with baseline) and partial responders (>/=25 but |
| Databáze: | OpenAIRE |
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