Deep brain stimulation of the subgenual cortex for treatment of refractory bipolar disorder: case report and literature review

Stimolazione cerebrale profonda della corteccia subgenuale per il trattamento del disturbo bipolare farmaco-resistente: case report e revisione della letteratura

G. Messina, M. Rizzi, R. Cordella, M. Castiglione, O. Gambini, A. Franzini

Department of Neurosurgery, Fondazione IRCCS Istituto Nazionale Neurologico “Carlo Besta”, Milan, Italy; 1 Department of Psychiatry, Ospedale “S. Paolo”, University of Milan, Italy

Summary

Introduction
Deep brain stimulation (DBS) has been proposed for the treatment of severe and refractory major depressive disorder, including DBS of Broadman’s area 25 (BA 25 subgenual cortex).

Report
We report DBS of this cerebral region in a patient affected bylong-lasting disabling and drug-resistant bipolar disorder previously submitted to electroconvulsive therapy (ECT) and vagal nerve stimulation (VNS).

Results
After the procedure and at 2.5 years follow-up the patient presented substantial improvement of depressive symptoms and maintained a stable drug therapy regimen

Discussion
Our results suggest a possible therapeutic role for BA 25 DBS even in patients affected by bipolar disorder previously treated by ECT and VNS.

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