• Juan Ángel Aibar-Durán, Rodrigo Rodríguez Rodríguez, Francisco Javier de Diego Adeliño, María J Portella, María Jesús Álvarez-Holzapfel, Ana Martín Blanco, Dolors Puigdemont Campos, and Molet TeixidóJoanJDepartment of Neurosurgery, Santa Creu i Sant Pau Hospital, Barcelona, Spain..
• Department of Neurosurgery, Santa Creu i Sant Pau Hospital, Barcelona, Spain.
• Neurosurgery. 2022 Jan 1; 90 (1): 72-80.

BackgroundLong-term efficacy and mechanisms of action of deep brain stimulation (DBS) for treatment-resistant depression (TRD) are under investigation.ObjectiveTo compare long-term outcomes with active electrode's coordinates and its electrical parameters in patients with TRD treated with DBS in the subgenual cingulate gyrus (SCG-DBS).MethodsSeventeen patients with TRD underwent SCG-DBS. Demographic and baseline characteristics were recorded. The 17-item Hamilton Depression Rating Scale was used to measure the response to the therapy. The anterior commissure-posterior commissure coordinates of the active contacts and the total electrical energy delivered were calculated and correlated with clinical outcomes. Patient-specific tractographic analysis was performed to identify the modulated pathways in responders.ResultsTwelve women (70.6%) and 5 men (29.4%) with a median age of 48 yr (34-70 years) were included. Along the 5-year follow-up, 3 main clinical trajectories were observed according to symptom's improvement: great responders (≥80%), medium responders (≥50%-79%), and poor responders (<50%). Active contacts' coordinates and total electrical energy delivered showed no correlation with clinical outcomes. Brodmann area 10 medial was the most frequently stimulated area and the forceps minor, the most frequently modulated tract.ConclusionSCG-DBS for TRD is clearly effective in some patients. Active contacts' coordinates were highly variable within the region and, like electrical parameters, did not seem to correlate with clinical outcomes. In the current series, Brodmann area 10 medial and the forceps minor were the most frequently targeted area and modulated pathway, respectively.Copyright © Congress of Neurological Surgeons 2021. All rights reserved.

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