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Case Reports
. 2021 Jan 13:11:616501.
doi: 10.3389/fpsyt.2020.616501. eCollection 2020.

Case Report: Lateral Habenula Deep Brain Stimulation for Treatment-Resistant Depression

Zhiyan Wang  1 , Xiaodong Cai  2 , Rirang Qiu  3 , Chen Yao  2 , Ye Tian  1 , Chen Gong  1 , Yingli Zhang  3 , Bin Xu  2 , Doudou Zhang  2 , Yu Zang  3 , Jiali Liu  2 , Bo Peng  3 , Luming Li  1   4   5   6
Affiliations
Case Reports

Case Report: Lateral Habenula Deep Brain Stimulation for Treatment-Resistant Depression

Zhiyan Wang et al. Front Psychiatry. .

Abstract

Treatment-resistant depression (TRD) is a chronic and severe psychiatric illness associated with limited therapeutic options. Deep brain stimulation (DBS) is a promising therapy for TRD patients. However, its safety and efficacy are still unclear. Here we reported the safety and efficacy of lateral habenula (LHb) DBS for a TRD patient who had failed medical, psychological, electroconvulsive, and ketamine therapy. The DBS system is compatible with 3T magnetic resonance imaging along with local field potential (LFP) streaming. Two DBS electrodes were implanted at the bilateral LHb without any complication. The patient showed acute stimulation effects and achieved long-term improvements in his depression, anxiety, and sleep with left LHb 160 Hz frequency stimulation, accompanying the change of LFPs. These results provided clinical evidence toward the safety and efficacy and electrophysiological basis of LHb DBS for TRD.

Keywords: deep brain stimualtion; lateral habenula; local field potentials; patient; treatment resistant depression.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Lead placement, electric fields, and estimated volumes of tissue activated for the stimulation settings post-implantation. (A) the estimated volumes of tissue affected for the left side stimulation settings (monopolar stimulation, L3-, 4.5 v, 160 Hz, 90 μs); (B) enlarged view of the electrode positions; (C) the estimated volumes of tissue affected for the right side stimulation settings (monopolar stimulation, R3-, 2.5 v, 160 Hz, 90 μs); (D) the electrodes in the transverse section; (E) the electrodes in the coronal section; (F) the electrodes in the median sagittal section.
Figure 2
Figure 2
Electrodes placement at 1 and 2-month after implantation with 3T MRI. (A,B) The electrodes in the median sagittal and coronal section at 1-month after implantation, respectively; (C,D) The electrodes in the median sagittal and coronal section at 2-month after implantation, respectively.
Figure 3
Figure 3
The consistent trends of the PSD at DBS off of the LHb and the clinical improvements of the patient at pre-operation, 1 and 3-month after stimulation. (A) The PSD at DBS off in all bands at pre-stimulation, 1 and 3-month after stimulation. (B) The average PSD had positive and consistent trends between the delta, theta, alpha, and beta bands and the clinical improvements at pre-operation, 1 and 3-month.
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