Researchers from the Cleveland Clinic Foundation and Brown University’s Butler Hospital have found that deep brain stimulation (DBS) is a potentially effective treatment option for people with major depression. "Since 2001, this team of investigators has been using DBS for treatment of obsessive-compulsive disorder. Because DBS for obsessive-compulsive disorder showed significant benefits in improving patients’ anxiety and obsessions, as well as improvements in comorbid depression, the research team initiated a new study analyzing the effects of DBS on patients with major depression," stated Ali R. Rezai, MD.

This study was conducted with Institutional Review Board and FDA Investigational Device Exemptions approval. Six patients (four females; average age, 48) were enrolled in the study from 2003 to 2005. All six patients had a history of high resistance to other treatments, including medication, psychotherapy, and electroconvulsive therapy. Bilateral DBS leads were implanted stereotactically in a region of the brain known as the ventral anterior internal capsule. Participants underwent standardized and detailed psychiatric, quality-of-life, and neuropsychological assessments on a regularly scheduled basis, both presurgically and postsurgically.

At a minimum of six months postsurgery, four of the six patients showed a clinically significant reduction (50% or greater) in depression severity on the Montgomery-Asberg Depression Rating Scale. Quality-of-life measures improved as well, and patients showed progressive improvements in mood and functioning over time. One patient experienced persistent occipital pain that was alleviated with repositioning of a subcutaneous connector wire.

"Overall, preliminary results indicate that bilateral DBS of the anterior limb of the internal capsule holds promise for the treatment of intractable major depression," stated Dr. Rezai.

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