Molecular basis and clinical perspectives of deep brain stimulation for major depressive disorder.

Teixeira, Saulo Araújo; Moreira, Jorge Lucas de Sousa; Sousa, Narah Régia Tavares; Pereira, Andrezza Maria de Carvalho; Rodrigues, Paloma Nóbrega; Santos, Adriano Siqueira dos; Andrade, Ana Maria Lima Carneiro de; Rolim Neto, Modesto Leite; Araújo, Jaime Emanuel Brito; Machado, Sávio Samuel Feitosa; Vieira, Nélio Barreto; Lima, Danielly Gonçalves Sombra; Filho, Francisco Helder Pereira

It is possible to consider the stimulation of the cingulate gyrus in its portion below the corpus callosum (SCC, or subcallosal cingulate cortex) as an effective, promising, and safe alternative intervention for treatment-resistant depression. In studies with deep brain stimulation - DBS, when follow-on with functional magnetic resonance imaging and/or PET-CT (Positron emission tomography–computed tomography) is performed, it is observed an increase in the blood supply and glucose metabolism in this region, which is the anterior part of the limbic system. This same location has good experimental results also for the treatment of anorexia nervosa. The hypotheses suggest a greater activation of the reward system, a greater sense of well-being, and a consequent reduction in depressive symptoms, the objective of the treatment. Over the last 20 years, multicenter studies have shown symptomatic improvement in 50–60% of patients, and about a third even reach criteria for remission of the depressive disorder.

Journal of Cerebral Blood Flow & Metabolism, 2022, Vol 42, Issue 4, p683

0271-678X

Academic Journal

10.1177/0271678X221074279