Depression is a common, severe psychiatric illness with an enormous individual and societal burden and limited therapeutic options. Unfortunately, between about 10 and 30% of depressed patients taking antidepressants and receiving psychotherapy are partially or totally resistant to these treatments, and even with electroconvulsive therapy, a significant number remain refractory between about 10 and 30% of depressed patients taking antidepressants and receiving psychotherapy are partially or totally resistant to these treatments, and even with electroconvulsive therapy, a significant number remain refractory. Thus, there is an urgent need for more effective treatments, especially for the most severely affected fraction of patients.
> …between about 10 and 30% of depressed patients taking antidepressants and receiving psychotherapy are partially or totally resistant to these treatments, and even with electroconvulsive therapy, a significant number remain refractory.
For the treatment of neurological symptoms, such as essential tremor, dystonia and Parkinson Disease, deep brain stimulation (DBS) has become a routine treatment. Given this success, the last decade has seen its application in small case series and individual cases to treat depression. Most of these studies have described successful treatment rates of around 30–50% in patients who had previously been characterised as treatment resistant.
Such an approach in treatment resistant depression (TRD) of course depends on the selection of suitable targets in the complex neural circuits mediating this brain disease. To be able to translate preclinical findings into human research, a valid animal model and a tool for translation are required. In our search for an appropriate target, we have used the congenital Learned Helpless (cLH) model, which uniquely models TRD. Inter alia , our established genetic …
[1]
Karl J. Friston,et al.
Covariation of Activity in Habenula and Dorsal Raphé Nuclei Following Tryptophan Depletion
,
1999,
NeuroImage.
[2]
A. Sartorius,et al.
Mechanisms of depression: the role of neurogenesis
,
2004
.
[3]
S. Cichon,et al.
Neural Mechanisms of a Genome-Wide Supported Psychosis Variant
,
2009,
Science.
[4]
O. Hikosaka.
The habenula: from stress evasion to value-based decision-making
,
2010,
Nature Reviews Neuroscience.
[5]
Peter Kirsch,et al.
Remission of Major Depression Under Deep Brain Stimulation of the Lateral Habenula in a Therapy-Refractory Patient
,
2010,
Biological Psychiatry.
[6]
R. Spanagel,et al.
Stress triggers anhedonia in rats bred for learned helplessness
,
2010,
Behavioural Brain Research.
[7]
Christophe D. Proulx,et al.
Synaptic potentiation onto habenula neurons in learned helplessness model of depression
,
2010,
Nature.
[8]
A. Sartorius,et al.
Pharmacological inhibition of the lateral habenula improves depressive-like behavior in an animal model of treatment resistant depression
,
2011,
Behavioural Brain Research.
[9]
S. H. Richter,et al.
A glass full of optimism: Enrichment effects on cognitive bias in a rat model of depression
,
2012,
Cognitive, Affective, & Behavioral Neuroscience.
[10]
K. Kiening,et al.
Deep Brain Stimulation of the Lateral Habenular Complex in Treatment-Resistant Depression: Traps and Pitfalls of Trajectory Choice
,
2013,
Neurosurgery.