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Impact of deep brain stimulation of the ventral anterior limb of the internal capsule on cognition in depression

Published online by Cambridge University Press:  09 February 2017

I. O. Bergfeld ,
M. Mantione ,
M. L. C. Hoogendoorn ,
H. G. Ruhé ,
F. Horst ,
P. Notten ,
J. van Laarhoven ,
P. van den Munckhof ,
G. Beute  and
P. R. Schuurman
...Show all authors
I. O. Bergfeld*
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Amsterdam Brain and Cognition, Amsterdam, The Netherlands
M. Mantione
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
M. L. C. Hoogendoorn
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
H. G. Ruhé
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Psychiatry, Mood and Anxiety Disorders, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
F. Horst
Affiliation:
Department of Psychiatry, ETZ, location Elisabeth, Tilburg, The Netherlands
P. Notten
Affiliation:
Department of Psychiatry, ETZ, location Elisabeth, Tilburg, The Netherlands
J. van Laarhoven
Affiliation:
Department of Psychiatry, ETZ, location Elisabeth, Tilburg, The Netherlands
P. van den Munckhof
Affiliation:
Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
G. Beute
Affiliation:
Department of Neurosurgery, ETZ, location Elisabeth, Tilburg, The Netherlands
P. R. Schuurman
Affiliation:
Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
D. Denys*
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Amsterdam Brain and Cognition, Amsterdam, The Netherlands Netherlands Institute for Neurosciences, an Institute of the Royal Dutch Academy of Science, Amsterdam, The Netherlands
*
*Address for correspondence: I. Bergfeld, M.Sc. and D. Denys, M.D. Ph.D., Department of Psychiatry, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands. (Email: i.o.bergfeld@amc.nl) [I. O. B.] (Email d.denys@gmail.com) [D. D.]
*Address for correspondence: I. Bergfeld, M.Sc. and D. Denys, M.D. Ph.D., Department of Psychiatry, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands. (Email: i.o.bergfeld@amc.nl) [I. O. B.] (Email d.denys@gmail.com) [D. D.]
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Abstract

Background

Preliminary studies report no negative and a possible positive impact of deep brain stimulation (DBS) on cognition of patients with treatment-resistant depression (TRD). However, these studies neither controlled for practice effects nor compared active with sham stimulation.

Method

To address these limitations, we compared 25 TRD patients, who underwent DBS of the ventral anterior limb of the internal capsule (vALIC), with 21 healthy controls (HCs) matched on gender, age and education level. Both groups did subtests of the Cambridge Neuropsychological Test Automated Battery assessing verbal and visuospatial memory, attention, cognitive flexibility, psychomotor functioning, planning and object naming. TRD patients were tested 3 weeks prior to DBS surgery (baseline), 3 weeks following surgery (T1) and following 52 weeks of DBS optimization (T2). HCs were tested at baseline, 6 weeks following baseline (T1) and 20–24 weeks following baseline (T2). Subsequently, TRD patients entered a randomized, double-blind crossover phase, in which they were tested in an active and a sham stimulation phase.

Results

TRD patients did not improve on a test of immediate verbal recognition from baseline to T1, whereas HCs did (group x time: p = 0.001). Both TRD patients and HCs improved over sessions on tests measuring delayed verbal recall, visuospatial memory, planning and object naming (all p < 0.01). Active and sham stimulation did not have an impact on any of the tests differentially.

Conclusions

vALIC DBS neither has a lasting positive nor negative impact on cognition in TRD patients. DBS surgery might have a temporary negative effect on verbal memory.

Keywords

Cognitive functionsdeep brain stimulationdepressive disorderneuropsychologytreatment-resistant depression
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 9 , July 2017 , pp. 1647 - 1658
Copyright
Copyright © Cambridge University Press 2017 

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