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The optimal location for electrode placement in deep brain stimulation (DBS) for depression remains unknown. To address this unanswered question, investigators examined results from whole-brain activation volume tractography in 16 patients with refractory depression treated for 2 years with bilateral DBS in subcallosal cingulate white matter. Imaging was performed at 6 months and at 2 years.
Six months after implantation, 6 patients responded (50% reduction in depression rating scale scores); at 2 years, 12 responded. All responders demonstrated activation along three bilateral pathways from the electrode:
To the medial frontal cortex via the anterior corpus callosum and medial uncinate fasciculus
To the rostral and dorsal anterior and mid-cin…