• Alexander S Taghva, Donald A Malone, and Ali R Rezai.
• Department of Neurological Surgery, Center for Neuromodulation, Ohio State University, Columbus, Ohio, USA; Orange County Neurosurgical Associates, Mission Viejo, California, USA. Electronic address: alextaghva@yahoo.com.
• World Neurosurg. 2013 Sep 1;80(3-4):S27.e17-24.

BackgroundMajor depressive disorder is a common and disabling illness and is the leading cause of disability worldwide. Despite aggressive medical, behavioral, and electroconvulsive therapies, a significant number of patients remain refractory to treatment. Deep brain stimulation (DBS) has proven efficacy in neurobehavioral disorders and, in a general sense, works by modulation of corticostriatopallidothalamocortical circuits implicated in these disorders.MethodsCurrent data, treatment rationales, and future directions are presented.ResultsThe two targets most commonly used for DBS in treatment-resistant depression are the subgenual cingulate gyrus and the ventral capsule/ventral striatum. Data on DBS of these regions are preliminary, with promise shown in early studies.ConclusionsEarly work suggests DBS may become a therapeutic option in treatment-resistant depression. Further study is justified given the immense burden of disease.Copyright © 2013. Published by Elsevier Inc.

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