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Andres M. Lozano - One of the best experts on this subject based on the ideXlab platform.
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The Subcallosal Cingulate Gyrus in the Context of Major Depression
Biological psychiatry, 2010Co-Authors: Clement Hamani, Helen S. Mayberg, Scellig S.d. Stone, Adrian W. Laxton, Suzanne N. Haber, Andres M. LozanoAbstract:The subcallosal Cingulate Gyrus (SCG), including Brodmann area 25 and parts of 24 and 32, is the portion of the cingulum that lies ventral to the corpus callosum. It constitutes an important node in a network that includes cortical structures, the limbic system, thalamus, hypothalamus, and brainstem nuclei. Imaging studies have shown abnormal SCG metabolic activity in patients with depression, a pattern that is reversed by various antidepressant therapies. The involvement of the SCG in mechanisms of depression and its emerging potential role as a surgical target for deep brain stimulation has focused recent interest in this area. We review anatomic and histologic attributes of the SCG and the morphologic and imaging changes observed in depression. Particular attention is given to the regional and downstream structures that could be influenced by the application of deep brain stimulation in this region.
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
FOCUS, 2010Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background:A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods:Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results:There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy ...
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
Biological Psychiatry, 2008Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy was associated with specific changes in the metabolic activity localized to cortical and limbic circuits implicated in the pathogenesis of depression. The number of serious adverse effects was small with no patient experiencing permanent deficits. Conclusions This study suggests that DBS is relatively safe and provides significant improvement in patients with TRD. Subcallosal Cingulate Gyrus DBS likely acts by modulating brain networks whose dysfunction leads to depression. The procedure is well tolerated and benefits are sustained for at least 1 year. A careful double-blind appraisal is required before the procedure can be recommended for use on a wider scale.
Helen S. Mayberg - One of the best experts on this subject based on the ideXlab platform.
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The Subcallosal Cingulate Gyrus in the Context of Major Depression
Biological psychiatry, 2010Co-Authors: Clement Hamani, Helen S. Mayberg, Scellig S.d. Stone, Adrian W. Laxton, Suzanne N. Haber, Andres M. LozanoAbstract:The subcallosal Cingulate Gyrus (SCG), including Brodmann area 25 and parts of 24 and 32, is the portion of the cingulum that lies ventral to the corpus callosum. It constitutes an important node in a network that includes cortical structures, the limbic system, thalamus, hypothalamus, and brainstem nuclei. Imaging studies have shown abnormal SCG metabolic activity in patients with depression, a pattern that is reversed by various antidepressant therapies. The involvement of the SCG in mechanisms of depression and its emerging potential role as a surgical target for deep brain stimulation has focused recent interest in this area. We review anatomic and histologic attributes of the SCG and the morphologic and imaging changes observed in depression. Particular attention is given to the regional and downstream structures that could be influenced by the application of deep brain stimulation in this region.
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
FOCUS, 2010Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background:A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods:Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results:There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy ...
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
Biological Psychiatry, 2008Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy was associated with specific changes in the metabolic activity localized to cortical and limbic circuits implicated in the pathogenesis of depression. The number of serious adverse effects was small with no patient experiencing permanent deficits. Conclusions This study suggests that DBS is relatively safe and provides significant improvement in patients with TRD. Subcallosal Cingulate Gyrus DBS likely acts by modulating brain networks whose dysfunction leads to depression. The procedure is well tolerated and benefits are sustained for at least 1 year. A careful double-blind appraisal is required before the procedure can be recommended for use on a wider scale.
Clement Hamani - One of the best experts on this subject based on the ideXlab platform.
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The Subcallosal Cingulate Gyrus in the Context of Major Depression
Biological psychiatry, 2010Co-Authors: Clement Hamani, Helen S. Mayberg, Scellig S.d. Stone, Adrian W. Laxton, Suzanne N. Haber, Andres M. LozanoAbstract:The subcallosal Cingulate Gyrus (SCG), including Brodmann area 25 and parts of 24 and 32, is the portion of the cingulum that lies ventral to the corpus callosum. It constitutes an important node in a network that includes cortical structures, the limbic system, thalamus, hypothalamus, and brainstem nuclei. Imaging studies have shown abnormal SCG metabolic activity in patients with depression, a pattern that is reversed by various antidepressant therapies. The involvement of the SCG in mechanisms of depression and its emerging potential role as a surgical target for deep brain stimulation has focused recent interest in this area. We review anatomic and histologic attributes of the SCG and the morphologic and imaging changes observed in depression. Particular attention is given to the regional and downstream structures that could be influenced by the application of deep brain stimulation in this region.
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
FOCUS, 2010Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background:A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods:Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results:There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy ...
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
Biological Psychiatry, 2008Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy was associated with specific changes in the metabolic activity localized to cortical and limbic circuits implicated in the pathogenesis of depression. The number of serious adverse effects was small with no patient experiencing permanent deficits. Conclusions This study suggests that DBS is relatively safe and provides significant improvement in patients with TRD. Subcallosal Cingulate Gyrus DBS likely acts by modulating brain networks whose dysfunction leads to depression. The procedure is well tolerated and benefits are sustained for at least 1 year. A careful double-blind appraisal is required before the procedure can be recommended for use on a wider scale.
Sydney H Kennedy - One of the best experts on this subject based on the ideXlab platform.
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
FOCUS, 2010Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background:A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods:Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results:There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy ...
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subcallosal Cingulate Gyrus deep brain stimulation for treatment resistant depression
Biological Psychiatry, 2008Co-Authors: Andres M. Lozano, Helen S. Mayberg, Clement Hamani, Peter Giacobbe, Cameron R Craddock, Sydney H KennedyAbstract:Background A preliminary report in six patients suggested that deep brain stimulation (DBS) of the subcallosal Cingulate Gyrus (SCG) may provide benefit in treatment-resistant depression (TRD). We now report the results of these and an additional 14 patients with extended follow-up. Methods Twenty patients with TRD underwent serial assessments before and after SCG DBS. We determined the percentage of patients who achieved a response (50% or greater reduction in the 17-item Hamilton Rating Scale for Depression [HRSD-17]) or remission (scores of 7 or less) after surgery. We also examined changes in brain metabolism associated with DBS, using positron emission tomography. Results There were both early and progressive benefits to DBS. One month after surgery, 35% of patients met criteria for response with 10% of patients in remission. Six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Deep brain stimulation therapy was associated with specific changes in the metabolic activity localized to cortical and limbic circuits implicated in the pathogenesis of depression. The number of serious adverse effects was small with no patient experiencing permanent deficits. Conclusions This study suggests that DBS is relatively safe and provides significant improvement in patients with TRD. Subcallosal Cingulate Gyrus DBS likely acts by modulating brain networks whose dysfunction leads to depression. The procedure is well tolerated and benefits are sustained for at least 1 year. A careful double-blind appraisal is required before the procedure can be recommended for use on a wider scale.
Victor Perez - One of the best experts on this subject based on the ideXlab platform.
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cognitive functioning after deep brain stimulation in subcallosal Cingulate Gyrus for treatment resistant depression an exploratory study
Psychiatry Research-neuroimaging, 2015Co-Authors: M Serrablasco, Sol De Vita, Mar Rivas Rodriguez, Javier De Diegoadelino, Dolors Puigdemont, Ana Martinblanco, Rosario Perezegea, J Molet, Enric Alvarez, Victor PerezAbstract:Deep brain stimulation (DBS) is being investigated as a therapeutic alternative for patients with treatment-resistant depression (TRD), but its cognitive safety has been scarcely explored. The aim of this exploratory study is to evaluate cognitive function of patients before and after deep brain stimulation of the subgenual Cingulate Gyrus (SCG). Eight treatment-resistant depressed patients were implanted in subgenual Cingulate Gyrus. A neuropsychological battery was used to evaluate patients before surgery and 1-year after. A matched group of eight first-episode patients was also assessed. A MANOVA was performed for each cognitive domain and those tests showing main time effects were then correlated with depressive symptoms and with medication load. There were significant group and time effects for memory and a group effect for language. No significant interactions between groups or cognitive domains were observed. Medication load was negatively correlated with memory at time 1, and clinical change negatively correlated with memory improvement. These findings support the cognitive safety of DBS of subgenual Cingulate Gyrus, as cognitive function did not worsen after chronic stimulation and memory performance even improved. The results, though, should be interpreted cautiously given the small sample size and the fact that some treatment-resistant patients received electroconvulsive therapy (ECT) before implantation.