• Acta Neurochir. Suppl. · Jan 2007

    Case Reports

    Neuromodulation of the inferior thalamic peduncle for major depression and obsessive compulsive disorder.

    • F Jiménez, F Velasco, R Salín-Pascual, M Velasco, H Nicolini, A L Velasco, and G Castro.
    • Functional Neurosurgery, Stereotactic and Radiosurgery Unit, Hospital General De México, Mexico City, Mexico. fiacroj@yahoo.com
    • Acta Neurochir. Suppl. 2007 Jan 1;97(Pt 2):393-8.

    AbstractNeuromodulation of the inferior thalamic peduncle is a new surgical treatment for major depression and obsessive-compulsive disorder. The inferior thalamic peduncle is a bundle of fibers connecting the orbito-frontal cortex with the non-specific thalamic system in a small area behind the fornix and anterior to the polar reticular thalamic nucleus. Electrical stimulation elicits characteristic frontal cortical responses (recruiting responses and direct current (DC)-shift) that confirm correct localization of this anatomical structure. A female with depression for 23 years and a male with obsessive-compulsive disorder for 9 years had stereotactic implantation of electrodes in the inferior thalamic peduncle and were evaluated over a long-term period. Initial OFF stimulation period (1 month) showed no consistent changes in the Hamilton Depression Scale (HAM-D), Yale Brown Obsessive Compulsive Scale (YBOCS), or Global Assessment of Functioning scale (GAF). The ON stimulation period (3-5 V, 130-Hz frequency, 450-msec pulse width in a continuous program) showed significant decrease in depression, obsession, and compulsion symptoms. GAF improved significantly in both cases. The neuropsychological tests battery showed no significant changes except from a reduction in the perseverative response of the obsessive-compulsive patient and better performance in manual praxias of the female depressive patient. Moderate increase in weight (5 kg on average) was observed in both cases.

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