TY - JOUR
T1 - Deep brain stimulation improves symptoms across all dimensions in treatment-resistant depression
AU - Runia, N.
AU - Mol, G.J.J.
AU - Denys, D.A.J.P.
AU - Ardon, H.
AU - Beute, G.
AU - Bot, M.
AU - de Waardt, D.A.
AU - de Knijff, D.W.W.
AU - Mocking, R.J.T.
AU - Notten, P.
AU - Rutten, G.J.M.
AU - Schuurman, P.R.
AU - van den Munckhof, P.
AU - van Laarhoven, J.
AU - van Wingen, G.A.
AU - Bergfeld, I.O.
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/9
Y1 - 2025/9
N2 - Deep brain stimulation (DBS) reduces depressive symptom scores in many patients with treatment-resistant depression (TRD). However, it is unclear whether the observed improvement is similar across various symptom dimensions (e.g., anhedonia, anxiety, insomnia) or if some require additional clinical attention. Using a retrospective chart review, we assessed the trajectory of HAM-D-17 and MADRS scores during vALIC or slMFB DBS treatment within different symptom dimensions (HAM-D-17: 1) affective/anhedonia, 2) somatic/anxiety, 3) insomnia; MADRS: 1) affective/anhedonia, 2) anxiety/vegetative, 3) hopelessness) after at least a 25 % symptom reduction (partial response) at any time during their treatment course (n = 34 for HAM-D-17, n = 25 for MADRS). Results showed that each of the assessed symptom dimensions was significantly reduced compared to baseline at each of the assessed time periods (last follow-up: 2–15 years) after (partial) DBS response onset, which occurred at a median of approximately 2.5 months. Additionally, there was a significant interaction effect between symptom dimension and time period (HAM-D-17: F (12,1655.46) = 5.46, p < 0.001; MADRS: F (12,938.73) = 2.40, p < 0.01). Model coefficients indicated that insomnia symptoms (HAM-D-17) and anxiety/vegetative symptoms (MADRS) improved at a slower rate than the other symptom dimensions. Additionally, higher baseline scores in the HAM-D-17 somatic/anxiety dimension were significantly associated with a larger percentage reduction in overall symptoms after DBS (n = 39, F (1,32) = 12.371, p < 0.01). Our findings demonstrate that DBS for TRD effectively treats depressive symptoms in all dimensions, although insomnia symptoms may improve at a slower rate, and that patients with more anxiety symptoms, who typically tend to have worse pharmacological treatment outcomes, may particularly benefit from DBS.
AB - Deep brain stimulation (DBS) reduces depressive symptom scores in many patients with treatment-resistant depression (TRD). However, it is unclear whether the observed improvement is similar across various symptom dimensions (e.g., anhedonia, anxiety, insomnia) or if some require additional clinical attention. Using a retrospective chart review, we assessed the trajectory of HAM-D-17 and MADRS scores during vALIC or slMFB DBS treatment within different symptom dimensions (HAM-D-17: 1) affective/anhedonia, 2) somatic/anxiety, 3) insomnia; MADRS: 1) affective/anhedonia, 2) anxiety/vegetative, 3) hopelessness) after at least a 25 % symptom reduction (partial response) at any time during their treatment course (n = 34 for HAM-D-17, n = 25 for MADRS). Results showed that each of the assessed symptom dimensions was significantly reduced compared to baseline at each of the assessed time periods (last follow-up: 2–15 years) after (partial) DBS response onset, which occurred at a median of approximately 2.5 months. Additionally, there was a significant interaction effect between symptom dimension and time period (HAM-D-17: F (12,1655.46) = 5.46, p < 0.001; MADRS: F (12,938.73) = 2.40, p < 0.01). Model coefficients indicated that insomnia symptoms (HAM-D-17) and anxiety/vegetative symptoms (MADRS) improved at a slower rate than the other symptom dimensions. Additionally, higher baseline scores in the HAM-D-17 somatic/anxiety dimension were significantly associated with a larger percentage reduction in overall symptoms after DBS (n = 39, F (1,32) = 12.371, p < 0.01). Our findings demonstrate that DBS for TRD effectively treats depressive symptoms in all dimensions, although insomnia symptoms may improve at a slower rate, and that patients with more anxiety symptoms, who typically tend to have worse pharmacological treatment outcomes, may particularly benefit from DBS.
KW - Deep brain stimulation
KW - Symptom dimensions
KW - Treatment-resistant depression
KW - Sleep Initiation and Maintenance Disorders/therapy
KW - Humans
KW - Middle Aged
KW - Male
KW - Treatment Outcome
KW - Deep Brain Stimulation/methods
KW - Depressive Disorder, Treatment-Resistant/therapy
KW - Female
KW - Adult
KW - Retrospective Studies
KW - Aged
UR - https://www.scopus.com/pages/publications/105007806097
U2 - 10.1016/j.neurot.2025.e00623
DO - 10.1016/j.neurot.2025.e00623
M3 - Article
C2 - 40500658
AN - SCOPUS:105007806097
SN - 1933-7213
VL - 22
JO - Neurotherapeutics
JF - Neurotherapeutics
IS - 5
M1 - e00623
ER -