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2. Deep Brain Stimulation (DBS)
Prof. Philip Cowen
Professor of Psychopharmacology
Department of Psychiatry
University of Oxford, UK

3. Deep Brain Stimulation (DBS)
Tracy DK, David AS. Clinical neuromodulation in psychiatry: the state of the art or an art in a state?. BJPsych Advances Nov 1;21(6):

4. Deep Brain Stimulation (DBS)
Treatment of Parkinson’s disease
Implantation of electrodes in the subthalamic nucleus
Mood improvement
Studies in depression
Tracy DK, David AS. Clinical neuromodulation in psychiatry: the state of the art or an art in a state?. BJPsych Advances Nov 1;21(6):

5. Deep Brain Stimulation (DBS)
Treatment of Parkinson’s disease
Implantation of electrodes in the subthalamic nucleus
Mood improvement
Studies in depression
Tracy DK, David AS. Clinical neuromodulation in psychiatry: the state of the art or an art in a state?. BJPsych Advances Nov 1;21(6):

6. Deep Brain Stimulation (DBS)
Treatment of Parkinson’s disease
Implantation of electrodes in the subthalamic nucleus
Mood improvement
Studies in depression

7. Deep Brain Stimulation (DBS)
Neurosurgical procedure
Stereotactic surgery
Depression: experimental treatment

8. Deep Brain Stimulation (DBS)
Neurosurgical procedure
Stereotactic surgery
Depression: experimental treatment

9. Deep Brain Stimulation (DBS)
Target regions
Subgenual cingulate cortex
Ventral striatum
Meta-analysis of four observational studies
12-month remission rate of 26 percent
highly treatment refractory patients
no benefit shown in sham controlled studies
Effectiveness remains to be shown

10. Deep Brain Stimulation (DBS)
Target regions
Subgenual cingulate cortex
Ventral striatum
Meta-analysis of four observational studies
12-month remission rate of 26 percent
highly treatment refractory patients
no benefit shown in sham controlled studies
Effectiveness remains to be shown

11. Deep Brain Stimulation (DBS)
Target regions
Subgenual cingulate cortex
Ventral striatum
Meta-analysis of four observational studies
12-month remission rate: 26 %
Highly treatment refractory patients
no benefit shown in sham controlled studies
Effectiveness remains to be shown
Berlim MT, McGirr A, Van den Eynde F, et al (2014) Effectiveness and acceptability of deep brain stimulation (DBS) of the subgenual cingulate cortex for treatment resistant depression: a systematic review and exploratory meta-analysis. Journal of Affective Disorders, 159: 31–8

12. Deep Brain Stimulation (DBS)
Target regions
Subgenual cingulate cortex
Ventral striatum
Meta-analysis of four observational studies
12-month remission rate:26%
No benefit shown in sham controlled studies
Effectiveness remains to be shown
Berlim MT, McGirr A, Van den Eynde F, et al (2014) Effectiveness and acceptability of deep brain stimulation (DBS) of the subgenual cingulate cortex for treatment resistant depression: a systematic review and exploratory meta-analysis. Journal of Affective Disorders, 159: 31–8

13. Key Points DBS Requires brain surgery
Its efficacy hasn’t yet been shown in controlled studies

14. Next Presentation: A Treatment Algorithm