Objective To investigate the efficacy and safety of deep brain stimulation of lateral habenula nucleus(LHb-DBS)for the treatment of refractory depression.Methods A prospective study was conducted on 6 patients with refractory depression who underwent deep brain stimulation of LHb-DBS in the Department of Neurosurgery of the First Medical Center of PLA General Hospital from March 2021 to April 2022.The Hamilton Depression Rating Scale(HDRS)-17,Hamilton Anxiety scale(HAMA),Montgomery-Åsberg Depression Rating Scale(MADRS),Pittsburgh Sleep Quality Index(PSQI),Quick Inventory of Depressive Symptomatology-Self-Report(QIDS-SR)and Global Assessment Function(GAF)were used for assessment 1 month before surgery and 1,3,6,9,12,and 15 months after surgery respectively.Complications related to surgery and stimulation were also documented.Results All 6 patients successfully underwent surgery.Five patients were followed up to 15 months after start-up of the DBS device,and one case was followed up to 1 month after start-up.At 1 month post start-up,the HDRS-17 score(average improvement rate:60.3％),HAMA score(average improvement rate:59.6％),MADRS score(average improvement rate:61.1％)and QIDS-SR score(average improvement rate:55.2％)were all decreased compared with the preoperative baseline,while the GAF score(average improvement rate:46.9％)was increased.In the follow-up of 3-15 months after start-up,compared with the preoperative baseline,the average improvement rate of depression-related scale HDRS-17,MADRS and QIDS-SR scores in 5 patients was 60.3％-67.6％,64.7％-79.4％and 47.4％-63.2％.For anxiety,the average improvement rate of HAMA score ranged from 57.7％to 71.6％.In terms of sleep,the average improvement rate of PSQI score was 17.2％-31.7％.The GAF score was increased by 47.6％-87.6％.During the perioperative period and follow-up period,there were no cases of surgery-related complications such as intraoperative hemorrhage,ischemia,or wound infection,and no device-related adverse events were observed.During the treatment period,stimulus-related adverse events were recorded in 4 patients,which were relieved after adjusting the stimulus contacts and stimulation parameters.Conclusions The treatment of patients with refractory depression with LHb-DBS can improve depression,anxiety and quality of life.No serious complications related to surgery or stimulation have been observed.
NETL
NSTL
中国科学院心理研究所
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