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Adverse Effects of Deep Brain Stimulation for Treatment-Resistant Depression: A Scoping Review.
Lapa, Jorge D S; Duarte, Joel F S; Campos, Ana Carolina P; Davidson, Benjamin; Nestor, Sean M; Rabin, Jennifer S; Giacobbe, Peter; Lipsman, Nir; Hamani, Clement.
Afiliación
  • Lapa JDS; Department of Medicine, Federal University of Sergipe, Aracaju , Sergipe , Brazil.
  • Duarte JFS; Department Neurosurgery, Hospital de Cirurgia, Aracaju , Sergipe , Brazil.
  • Campos ACP; Department Neurosurgery, Neurological Institute of Curitiba, Curitiba , Brazil.
  • Davidson B; Sunnybrook Research Institute, Toronto , Canada.
  • Nestor SM; Sunnybrook Research Institute, Toronto , Canada.
  • Rabin JS; Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto , Canada.
  • Giacobbe P; Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto , Canada.
  • Lipsman N; Sunnybrook Research Institute, Toronto , Canada.
  • Hamani C; Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto , Canada.
Neurosurgery ; 95(3): 509-516, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-38511957
ABSTRACT
Deep brain stimulation (DBS) is an emerging therapy for treatment-resistant depression (TRD). Although adverse effects have been reported in early-phase and a few randomized clinical trials, little is known about its overall safety profile, which has been assumed to be similar to that of DBS for movement disorders. The objective of this study was to pool existing safety data on DBS for TRD. Following PRISMA guidelines, PubMed was searched for English articles describing adverse outcomes after DBS for TRD. Studies were included if they reported at least 5 patients with a minimal follow-up of 6 months. After abstract (n = 607) and full-article review (n = 127), 28 articles reporting on 353 patients met criteria for final inclusion. Follow-up of the studies retrieved ranged from 12 to 96 months. Hemorrhages occurred in 0.8% of patients and infections in 10.2%. The rate of completed suicide was 2.5%. Development or worsening of depressive symptoms, anxiety, and mania occurred in 18.4%, 9.1%, and 5.1%, respectively. There were some differences between targets, but between-study heterogeneity precluded statistical comparisons. In conclusion, DBS for TRD is associated with surgical and psychiatric adverse events. Hemorrhage and infection occur at rates within an accepted range for other DBS applications. The risk of suicide after DBS for TRD is 2.5% but may not represent a significant deviation from the natural history of TRD. Finally, risks of worsening depression, anxiety, and the incidence of mania should be acknowledged when considering DBS for TRD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación Encefálica Profunda / Trastorno Depresivo Resistente al Tratamiento Límite: Humans Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación Encefálica Profunda / Trastorno Depresivo Resistente al Tratamiento Límite: Humans Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos