The nucleus accumbens: a target for deep brain stimulation in resistant major depressive disorder.

Journal of molecular psychiatry Pub Date : 2013-10-23 eCollection Date: 2013-01-01 DOI:10.1186/2049-9256-1-17
Cecilia Nauczyciel, Suzanne Robic, Thibaut Dondaine, Marc Verin, Gabriel Robert, Dominique Drapier, Florian Naudet, Bruno Millet
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引用次数: 61

Abstract

Objective: This review aimed to investigate the therapeutic potential of Deep Brain Stimulation (DBS) for treating resistant Major Depressive Disorder (MDD). We explored the role of Nucleus accumbens (Nac) as a target for treatment.

Method: We made a systematic review of all studies examining the mechanisms of action of high frequency brain stimulation and the pathophysiology of MDD. We also reported all the studies exploring the therapeutic potential of DBS in MDD.

Results: As a central relay-structure, the Nac seems to play a central role in MDD symptomatology. We investigated its role as a primary target for DBS in depressed patients. Anatomically the Nac is at the centre of the interactions between dopaminergic, serotoninergic and glutamatergic systems. Functionally, the Nac is involved in both normal and abnormal reward processes and in anhedonia and loss of motivation. Due to its central location between the emotional system, the cognitive system and motor control system, the Nac seems to have a central role in mood and feeling regulation.

Conclusion: According to encouraging recent studies, DBS seems to be a promising technique in resistant MDD treatment.

Abstract Image

伏隔核:抵抗性重度抑郁症深部脑刺激的目标。
目的:探讨脑深部电刺激(DBS)治疗顽固性重度抑郁症(MDD)的治疗潜力。我们探索伏隔核(Nac)作为治疗靶点的作用。方法:对高频脑刺激的作用机制和重度抑郁症的病理生理研究进行系统综述。我们也报道了所有探索DBS治疗重度抑郁症潜力的研究。结果:Nac作为一种中枢传递结构,似乎在重度抑郁症的症状学中起着核心作用。我们研究了它作为抑郁症患者DBS的主要靶点的作用。解剖学上,Nac是多巴胺能、血清素能和谷氨酸能系统相互作用的中心。在功能上,Nac参与正常和异常的奖励过程,并参与快感缺乏和动机丧失。由于其位于情绪系统、认知系统和运动控制系统之间的中心位置,Nac似乎在情绪和感觉调节中起着核心作用。结论:根据最近令人鼓舞的研究,DBS似乎是一种有希望的治疗耐药MDD的技术。
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