Potential Surgical Targets For Deep Brain Stimulation In Treatment-Resistant Depression

Jason S. Hauptman, MD; Antonio A. F. DeSalles, MD, PhD; Randall Espinoza, MD, MPH; Mark Sedrak, MD; Warren Ishida, MD


Neurosurg Focus. 2008;25(1):E3 

In This Article


Neuromodulation of the limbic circuit shows great potential for restoring functionality to patients crippled by TRD. Although the ventral striatum/NAC, subgenual cingulate cortex, ITP, rostral cingulate cortex, and lateral habenula are all reasonable targets for DBS electrode implantation, the stimulation of any of these locations is likely to modify the same or similar circuits, as the different areas appear to be anatomically and functionally related. Whereas early case reports and series have provided promising data regarding functional outcome, it is clear that a large-scale trial must be conducted to adequately assess the safety and efficacy of stimulation for depression. Data from such studies will provide information regarding optimal target localization, stimulation parameters, and adverse effects.

This is a critical and exciting time for the functional neurosurgeon. Modern neuromodulation now offers hope to many people who may regain the capacity for normal social interaction and eventually return to work. Beyond the negative history of psychosurgery, we have the opportunity to advance and broaden the spectrum of DBS applications. A solid scientific rationale, a flawless experimental protocol, and an adherence to a strong code of ethics are vital to ensuring the success of these endeavors.


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