Editing Deep brain stimulation (section)

=== Depression ===
Though depression can be a contraindication for electrostimulation of other chronic neurologic diseases in the basal ganglia, the therapy can also be used for treatment of severe depression. The target for electrostimulation in depression is more [[anterior]] and superficial at the frontal lobes, as opposed to other motor disorders where it is deeper in the basal ganglia. Beginning in the 1950s, treatment has been attempted in the [[Brodmann area 25|subcallosal cingulate region]]<ref>{{Cite journal |last1=Mayberg |first1=Helen S. |date=March 2005 |title=Deep Brain Stimulation for Treatment-Resistant Depression |url=https://linkinghub.elsevier.com/retrieve/pii/S089662730500156X |journal=Neuron |language=en |volume=45 |issue=5 |pages=651–660 |doi=10.1016/j.neuron.2005.02.014|pmid=15748841 }}</ref> and the ventral capsule/ventral striatum <ref>{{Cite journal |last1=Dougherty |first1=Darin D. |date=August 2015 |title=A Randomized Sham-Controlled Trial of Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Chronic Treatment-Resistant Depression |url=https://linkinghub.elsevier.com/retrieve/pii/S0006322314009688 |journal=Biological Psychiatry |language=en |volume=78 |issue=4 |pages=240–248 |doi=10.1016/j.biopsych.2014.11.023|pmid=25726497 |url-access=subscription }}</ref> have shown mixed outcomes.

[[Diffusion tensor tractography|Diffusion-weighted imaging based tractography]] has led to the theoretical discovery of the so-called 'depression switch',<ref>{{Cite journal |last1=Choi |first1=Ki Sueng |last2=Riva-Posse |first2=Patricio |last3=Gross |first3=Robert E. |last4=Mayberg |first4=Helen S. |date=2015-11-01 |title=Mapping the "Depression Switch" During Intraoperative Testing of Subcallosal Cingulate Deep Brain Stimulation |journal=JAMA Neurology |language=en |volume=72 |issue=11 |pages=1252–1260 |doi=10.1001/jamaneurol.2015.2564 |issn=2168-6149 |pmc=4834289 |pmid=26408865}}</ref> the intersection of four bundles that allowed more deliberate targeting of DBS in the subcallosal area and improved results in additional open-label studies.<ref>{{Cite journal |last1=Riva-Posse |first1=P |date=April 2018 |title=A connectomic approach for subcallosal cingulate deep brain stimulation surgery: prospective targeting in treatment-resistant depression |journal=Molecular Psychiatry |language=en |volume=23 |issue=4 |pages=843–849 |doi=10.1038/mp.2017.59 |issn=1359-4184 |pmc=5636645 |pmid=28397839}}</ref> While anatomical descriptions as well as supposed mechanisms for this target site have been debated,<ref>{{Cite journal |last1=Haber |first1=Suzanne N. |last2=Yendiki |first2=Anastasia |author-link2=Anastasia Yendiki |last3=Jbabdi |first3=Saad |date=November 2021 |title=Four Deep Brain Stimulation Targets for Obsessive-Compulsive Disorder: Are They Different? |journal=Biological Psychiatry |language=en |volume=90 |issue=10 |pages=667–677 |doi=10.1016/j.biopsych.2020.06.031 |pmc=9569132 |pmid=32951818}}</ref><ref>{{Cite journal |last1=Bouthour |first1=Walid |last2=Mégevand |first2=Pierre |last3=Donoghue |first3=John |last4=Lüscher |first4=Christian |last5=Birbaumer |first5=Niels |last6=Krack |first6=Paul |date=June 2019 |title=Biomarkers for closed-loop deep brain stimulation in Parkinson disease and beyond |url=https://www.nature.com/articles/s41582-019-0166-4 |journal=Nature Reviews Neurology |language=en |volume=15 |issue=6 |pages=343–352 |doi=10.1038/s41582-019-0166-4 |pmid=30936569 |issn=1759-4758|url-access=subscription }}</ref> clinical effects of this DBS target in patients with TRD have been promising.<ref>{{Cite journal |last1=Bewernick |first1=Bettina H. |last2=Kayser |first2=Sarah |last3=Gippert |first3=Sabrina M. |last4=Switala |first4=Christina |last5=Coenen |first5=Volker A. |last6=Schlaepfer |first6=Thomas E. |date=May 2017 |title=Deep brain stimulation to the medial forebrain bundle for depression- long-term outcomes and a novel data analysis strategy |url=https://linkinghub.elsevier.com/retrieve/pii/S1935861X17306034 |journal=Brain Stimulation |language=en |volume=10 |issue=3 |pages=664–671 |doi=10.1016/j.brs.2017.01.581|pmid=28259544 |url-access=subscription }}</ref>