Use of Deep Brain Stimulation in Depression?- Opportunities and Risks. Conclusions Based On the Results of Author's Research.

Abstract

Currently work is underway on the use of DBS in psychiatry, particularly in the population of patients with treatment-resistant depression. Authors summarize the current state of knowledge, risks and benefits associated with the use of DBS and try to specify the position of DBS in the treatment of depression. Conclusions are based on a review of the literature and the results of research conducted in the Department of Neurosurgery in Institute of Psychiatry and Neurology (Warsaw).

The study group included 60 patients with Parkinson's disease surgically treated by implantation of subthalamic nucleus stimulator (STN -DBS). The aim of the study was to assess the mental state of patients before and after implantation of STN-DBS, with particular attention to the presence of depression and anhedonia. This study showed an improvement in mental status, which has followed within a month after the start of stimulation and manifested in the improvement of mood, reduction of sadness, apathy and anhedonia. The trend towards improvement was maintained over the following months. The assessment carried out six months after DBS implantation showed reduction in score in HADRS, MADRS, BDI compared to the state before the operation. Anhedonia reduction observed during the first 30 days after initiating the stimulation persisted in the assessment six months after DBS implantation.

There is a need of systematic study of population treated with DBS using standardized measures. Data on effectivness and side-effects of DBS would be extremely useful for further research on the use of DBS in psychiatric disorders.