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Deep brain stimulation (DBS) of the subgenual cingulate cortex or internal capsule for treatment-resistant depression has elicited much interest (JW Psychiatry Nov 2 2009). Two preliminary open studies, which received some manufacturer support, describe a new target for DBS and an alternative, less-invasive approach.
Researchers in Germany implanted DBS electrodes bilaterally in the nucleus accumbens in 10 patients with major depression (mean illness duration, 19 years; mean length of current episode, 11 years). Patients had failed to respond to numerous antidepressant trials, ECT, and psychotherapy (mean, 21 adequate treatment trials). One year after implantation, five patients responded (a rate similar to those reported for other DBS targe…