Deep brain stimulation of the 'medial forebrain bundle': a strategy to modulate the reward system and manage treatment-resistant depression
| العنوان: | Deep brain stimulation of the 'medial forebrain bundle': a strategy to modulate the reward system and manage treatment-resistant depression |
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| المؤلفون: | Jair C. Soares, João Quevedo, Albert J. Fenoy |
| المصدر: | Molecular Psychiatry. 27:574-592 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 0301 basic medicine, Deep brain stimulation, Anhedonia, Deep Brain Stimulation, medicine.medical_treatment, Context (language use), Depressive Disorder, Treatment-Resistant, 03 medical and health sciences, Cellular and Molecular Neuroscience, Reward system, 0302 clinical medicine, Reward, medicine, Animals, Humans, Medial forebrain bundle, Molecular Biology, Depression, business.industry, Medial Forebrain Bundle, Cognition, medicine.disease, Psychiatry and Mental health, 030104 developmental biology, Forebrain, Quality of Life, medicine.symptom, business, Neuroscience, Treatment-resistant depression, 030217 neurology & neurosurgery |
| الوصف: | The medial forebrain bundle-a white matter pathway projecting from the ventral tegmental area-is a structure that has been under a lot of scrutinies recently due to its implications in the modulation of certain affective disorders such as major depression. In the following, we will discuss major depression in the context of being a disorder dependent on multiple relevant networks, the pathological performance of which is responsible for the manifestation of various symptoms of the disease which extend into emotional, motivational, physiological, and also cognitive domains of daily living. We will focus on the reward system, an evolutionarily conserved pathway whose underperformance leads to anhedonia and lack of motivation, which are key traits in depression. In the field of deep brain stimulation (DBS), different "hypothesis-driven" targets have been chosen as the subject of clinical trials on efficacy in the treatment-resistant depressed patient. The "medial forebrain bundle" is one such target for DBS, and has had remarkably rapid success in alleviating depressive symptoms, improving anhedonia and motivation. We will review what we have learned from pre-clinical animal studies on defining this white matter tract, its connectivity, and the complex molecular (i.e., neurotransmitter) mechanisms by which its modulation exerts its effects. Imaging studies in the form of tractographic depictions have elucidated its presence in the human brain. Such has led to ongoing clinical trials of DBS targeting this pathway to assess efficacy, which is promising yet still lack in sufficient numbers. Ultimately, one must confirm the mechanism of action and validate proof of antidepressant effect in order to have such treatment become mainstream, to promote widespread improvement in the quality of life of suffering patients. |
| تدمد: | 1476-5578 1359-4184 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4300530998a50be50ffb0f55e32601a9Test https://doi.org/10.1038/s41380-021-01100-6Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....4300530998a50be50ffb0f55e32601a9 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14765578 13594184 |
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