Brain-derived neurotrophic factor and subcallosal deep brain stimulation for refractory depression |
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Authors: | Rajamannar Ramasubbu Haley A Vecchiarelli Matthew N Hill Zelma HT Kiss |
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Institution: | 1. Departments of Psychiatry, University of Calgary, Calgary, AB, Canada;2. Department of Clinical Neuroscience, University of Calgary, AB, Canada;3. Mathison Centre for Mental Health Research and Education, University of Calgary, AB, Canada;4. Hotchkiss Brain Institute, University of Calgary, AB, Canada;5. Mathison Centre for Mental Health Research and Education, University of Calgary, AB, Canada;6. Department of Neuroscience, University of Calgary, AB, Canada;7. Department of Cell Biology and Anatomy, University of Calgary, AB, Canada;8. Department of Clinical Neuroscience, University of Calgary, AB, Canada |
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Abstract: | Objectives. Subcallosal cingulate (SCC) deep brain stimulation (DBS) is a promising experimental treatment for treatment-resistant depression (TRD). Given the role of brain-derived neurotrophic factor (BDNF) in neuroplasticity and antidepressant efficacy, we examined the effect of SCC-DBS on serum BDNF in TRD. Methods. Four patients with TRD underwent SCC-DBS treatment. Following a double-blind stimulus optimization phase of 3 months, patients received continuous stimulation in an open label fashion for 6 months. Clinical improvement in depressive symptoms was evaluated bi-weekly for 6 months using the Hamilton Depression Rating Scale (HDRS). Mature serum BDNF levels were measured before and 9–12 months after surgery. Results. Three patients responded to SCC-DBS: two showed full clinical response (50% reduction in HDRS scores) and one had partial response (35% reduction in HDRS scores) at the clinical endpoint. Interestingly, all four patients showed reduction in serum BDNF concentration from pre-DBS baseline. Conclusions. SCC-DBS for TRD may be associated with decreased levels of serum BDNF. Longitudinal studies with multiple measurements in a larger sample are required to determine the role of BDNF as a biomarker of SCC-DBS antidepressant efficacy. |
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Keywords: | brain-derived neurotrophic factor depression deep brain stimulation subcallosal cingulate region biomarker |
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