10. Deep Brain Stimulation in Treatment of Refractory Major Depression

  1. Sam Eljamel3 and
  2. Konstantin V. Slavin4
  1. Clement Hamani1 and
  2. Paul E. Holtzheimer2

Published Online: 19 JUL 2013

DOI: 10.1002/9781118346396.ch10

Neurostimulation: Principles and Practice

Neurostimulation: Principles and Practice

How to Cite

Hamani, C. and Holtzheimer, P. E. (2013) Deep Brain Stimulation in Treatment of Refractory Major Depression, in Neurostimulation: Principles and Practice (eds S. Eljamel and K. V. Slavin), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118346396.ch10

Editor Information

  1. 3

    Centre for Neurosciences, Ninewells Hospital & Medical School, Dundee, Scotland, UK

  2. 4

    Department of Neurosurgery, University of Illinois at Chicago. Chicago, Illinois, USA

Author Information

  1. 1

    Toronto Western Hospital and Centre for Addiction and Mental Health, Toronto, Ontario, Canada

  2. 2

    Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire , USA

Publication History

  1. Published Online: 19 JUL 2013
  2. Published Print: 19 AUG 2013

ISBN Information

Print ISBN: 9781118346358

Online ISBN: 9781118346396



  • deep brain stimulation (DBS);
  • inferior thalamic peduncle (ITP);
  • lateral habenula (LHb);
  • nucleus accumbens;
  • subcallosal cingulate gyrus (SCG);
  • treatment of refractory major depression (TRMD);
  • ventral capsule (VC);
  • ventral striatum (VS)


This chapter reviews the clinical outcome of deep brain stimulation (DBS) in various targets for the treatment of refractory major depression (TRMD). According to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DMS‐IV), diagnostic criteria for major depression disorder (MDD) involve the presence of single or multiple major depressive episodes (MDEs), as well as the absence of manic, mixed (combined depressive and manic episode), or hypomanic episodes. DBS targets proposed to date for the surgical treatment of depression are the subcallosal cingulate gyrus (SCG), the inferior thalamic peduncle (ITP), the nucleus accumbens (Acb), the ventral capsule (VC)/ventral striatum (VS), and lateral habenula (LHb). Patients undergoing this test are evaluated at baseline (without medication) and after receiving levodopa. The response obtained with this drug gives a general idea about the improvement that might be expected with surgery.