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A narrative review on invasive brain stimulation for treatment-resistant depression.
Dandekar, Manoj P; Diaz, Alexandre P; Rahman, Ziaur; Silva, Ritele H; Nahas, Ziad; Aaronson, Scott; Selvaraj, Sudhakar; Fenoy, Albert J; Sanches, Marsal; Soares, Jair C; Riva-Posse, Patricio; Quevedo, Joao.
Afiliação
  • Dandekar MP; Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India.
  • Diaz AP; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
  • Rahman Z; Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India.
  • Silva RH; Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.
  • Nahas Z; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
  • Aaronson S; Clinical Research Programs, Sheppard Pratt Health System, Baltimore, MD, USA.
  • Selvaraj S; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
  • Fenoy AJ; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
  • Sanches M; Deep Brain Stimulation Program, Department of Neurosurgery, McGovern Medical School, UTHealth, Houston, TX, USA.
  • Soares JC; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
  • Riva-Posse P; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
  • Quevedo J; Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
Braz J Psychiatry ; 44(3): 317-330, 2022.
Article em En | MEDLINE | ID: mdl-34468549
While most patients with depression respond to pharmacotherapy and psychotherapy, about one-third will present treatment resistance to these interventions. For patients with treatment-resistant depression (TRD), invasive neurostimulation therapies such as vagus nerve stimulation, deep brain stimulation, and epidural cortical stimulation may be considered. We performed a narrative review of the published literature to identify papers discussing clinical studies with invasive neurostimulation therapies for TRD. After a database search and title and abstract screening, relevant English-language articles were analyzed. Vagus nerve stimulation, approved by the U.S. Food and Drug Administration as a TRD treatment, may take several months to show therapeutic benefits, and the average response rate varies from 15.2-83%. Deep brain stimulation studies have shown encouraging results, including rapid response rates (> 30%), despite conflicting findings from randomized controlled trials. Several brain regions, such as the subcallosal-cingulate gyrus, nucleus accumbens, ventral capsule/ventral striatum, anterior limb of the internal capsule, medial-forebrain bundle, lateral habenula, inferior-thalamic peduncle, and the bed-nucleus of the stria terminalis have been identified as key targets for TRD management. Epidural cortical stimulation, an invasive intervention with few reported cases, showed positive results (40-60% response), although more extensive trials are needed to confirm its potential in patients with TRD.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estimulação Encefálica Profunda / Transtorno Depressivo Resistente a Tratamento Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Humans Idioma: En Revista: Braz J Psychiatry Assunto da revista: PSIQUIATRIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Índia País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estimulação Encefálica Profunda / Transtorno Depressivo Resistente a Tratamento Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Humans Idioma: En Revista: Braz J Psychiatry Assunto da revista: PSIQUIATRIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Índia País de publicação: Brasil