Efficacy of Deep Brain Stimulation: Subcallosal Cingulate Cortex Activity Holds the Key

Depressed people show hyperactivity in the subgenual anterior cingulate cortex (Brodmann area 25), and those with less hyperactivity in this area have shown greater response to selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT). A non–FDA-approved treatment is deep brain stimulation (DBS), which commonly targets the subcallosal cingulate cortex (SCC; mainly consisting of Brodmann area 25). Small studies have suggested that the degree of DBS inhibition of SCC activity is related to the amount of reduction of depression.

Researchers followed 20 people with treatment-resistant depression who received SCC-targeted DBS; 10 patients responded, and 10 did not. Fluorodeoxyglucose-positron emission tomography (PET)…