Characterizing the therapeutic response to deep brain stimulation for treatment-resistant depression: a single center long-term perspective.
Characterizing the therapeutic response to deep brain stimulation for treatment-resistant depression: a single center long-term perspective.
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DOI：
10.3389/fnint.2015.00041
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发表时间：
2015
影响因子：
3.5
通讯作者：
Mayberg HS
中科院分区：
文献类型：
--
作者：
Crowell AL;Garlow SJ;Riva-Posse P;Mayberg HS
接受深部脑刺激（DBS）治疗的抑郁症患者数量相对较少。然而，在一些研究中心，这种干预的经验现在已经超过了10年，研究对象通常受到密切监测。在这里，我们描述了一个中心对胼胝体下扣带（SCC） DBS的最佳患者选择的不断发展的印象，以及对抗抑郁反应和情绪反应的短期和长期模式的观察。观察到具有不同行为阶段的一致的治疗反应时间过程。早期阶段的特点是情绪反应的变化和在反应稳定之前自我评价的短暂和可预测的恶化。假设这一特征恢复曲线反映了脑深部脑刺激后神经可塑性的时间轴。对这些新出现的可预测的精神病学、生物学和社会心理模式的进一步研究，将改善治疗优化，增强对DBS抗抑郁药物有意义作用的理解和认识。
The number of depressed patients treated with deep brain stimulation (DBS) is relatively small. However, experience with this intervention now spans more than 10 years at some centers, with study subjects typically monitored closely. Here we describe one center’s evolving impressions regarding optimal patient selection for DBS of the subcallosal cingulate (SCC) as well as observations of short- and long-term patterns in antidepressant response and mood reactivity. A consistent time course of therapeutic response with distinct behavioral phases is observed. Early phases are characterized by changes in mood reactivity and a transient and predictable worsening in self ratings prior to stabilization of response. It is hypothesized that this characteristic recovery curve reflects the timeline of neuroplasticity in response to DBS. Further investigation of these emerging predictable psychiatric, biological, and psychosocial patterns will both improve treatment optimization and enhance understanding and recognition of meaningful DBS antidepressant effects.