Table 2.
Summary of clinical deep brain stimulation (DBS) studies for drug addiction and depression.
| Disorder | N | Follow-up (month) | Design | Electrode type | Amplitude (V) | Frequency (Hz) | Pulse width (μs) | Drug | Outcome | References |
|---|---|---|---|---|---|---|---|---|---|---|
| D | 3 | 0.5–2 | Double-blind manner | Bilateral | 4 | 145 | 90 | – | Clinical ratings improved, response rate = 33%. | Schlaepfer et al. (2008) |
| D | 10 | 12 | Open-label study | Bilateral | 1.5–10.0 | 100–150 | 60–210 | – | Anti-depressant and antianhedonic effects in TRD patients, response rate = 50%, remission rate = 30% | Bewernick et al. (2010) |
| D | 10 | 12 | Open-label study | Bilateral | 1.5–10.0 | 100–150 | 60–210 | – | Support cognitive safety of NAc-DBS and improve cognitive performance in patients with TRD. | Grubert et al. (2011) |
| D | 11 | 12–48 | Open-label study | Bilateral | 5.0–8.0 | 130 | 90 | – | A stable antidepressant and anxiolytic effect and an amelioration of quality of life in TRD patients, response rate = 45%, remission rate = 9%. | Bewernick et al. (2012) |
| D | 4 | 15 | Open-label study | Bilateral | 4.0–8.0 | 130 | 60 | – | NAc is a more promising target than the caudate, response rate=75%, remission rate=25%. | Millet et al. (2014) |
| A/D | 1 | 12 | Open-label study | Bilateral | 3 | 130 | 90 | Alcohol | No change in anxiety/depression, resolution of preop alcohol dependency. | Kuhn et al., 2009 |
| A | 3 | 12–18 | Open-label study | Bilateral | 3.5–4.5 | 130 | 90 | Alcohol | Two remained abstinent, while one showed a remarkable reduction of days while drinking | Müller et al. (2009) |
| A | 4 | 14 | Open-label study | Bilateral | 3.5–4.5 | 130 | 90 | Alcohol | All three patients reported a marked to nearly complete reduction of craving, NAc is indeed sensitive to alcohol-related cues. | Heinze et al. (2009) |
| A | 1 | 72 | Open-label study | Bilateral | 2.5 | 145 | 90 | Heroin | Procedure refrained from drug abusing during active stimulation for the first 2.5 years. He had remained drug free for 3.5 years even after the stimulation was removed with no relapse, the Self-Rating Depression Scale and Self-Rating Anxiety Scale decreased and returned to normal ranges on DBS stimulation. | Zhou et al. (2011) |
| A | 1 | 12 | Open-label study | Bilateral | 5.5 | 130 | 120 | Alcohol | Led to a significant reduction of drug consumption and modulated associated deficits in cognitive control. | Kuhn et al. (2011) |
| A | 1 | 6 | Open-label study | Bilateral | 3.5 | 180 | 90 | Heroin | The patient first reduced his use to the weekends and then succeeded in cessation of his heroin use; he was clean for more than 6 months with the exception of a 14-day relapse. | Valencia-Alfonso et al. (2012) |
| A | 5 | 31–47 | Off-label study | Bilateral | 4.5 | 130 | 90 | Alcohol | All patients experienced significant and ongoing improvement of craving. Two patients remained completely abstinent for more than 4 years. | Voges et al. (2013) |
| A | 2 | 24 | Open-label study | Bilateral | 4.5/5 | 130/140 | 90/120 | Heroin | Both patients were yet consuming other psychotropic substances (Patient 1: alcohol and amphetamines, Patient 2: amphetamines and benzodiazepines). | Kuhn et al. (2014) |
| A | 1 | 30 | 6 months of double-blinded 3 months of single-blinded | Bilateral | 2.5–4.5 | 150 | 150 | Cocaine | Posterior NAc and the bed nucleus of the stria terminalis (BNST) DBS was useful and safe for the treatment of this case of refractory cocaine dependence (RCD), and its positive effect was maintained >2.5 years after surgery. | Gonçalves-Ferreira et al. (2016) |
| A/D | 7 | 3–40 | Single-blinded | NAc /ALIC | ALIC = 2.0–2.5 NAc = 2.2–3.3 | ALIC = 150–240 NAc = 180–240 | ALIC = 185 N = 145 | Heroin | For all patients, an instant positive psychobehavioral response. Theta power in the ALIC/dorsal striatum and alpha power in the NAc may be associated with drug cravings and depressive symptoms, respectively, in heroin addicts. | Ge et al. (2018) |
| A | 8 | >24 | Open-label study | NAc/ALIC | 1.5–7 | 130–185 | 150–240 | Heroin | With DBS, five patients were abstinent for more than 3 years, two relapsed after abstaining for 6 months, and one was lost of follow-up at 3 months. The degree of cravings for drug use after DBS was reduced if the patients remained abstinent. Simultaneous DBS of the NAc and ALIC also improved the quality of life, alleviated psychiatric symptoms. | Chen et al. (2019) |
| A | 60 | 6 | Double-blinded study | NAc/ALIC | ALIC = 3 NAc = 3 | ALIC = 165 NAc = 145 | ALIC = 210 NAc = 210 | Opioid | Anticipated to be concluded by July 2020. | Qu et al. (2019) |
A, addiction; D, depression; N, Number of participants; ALIC, anterior limb of the internal capsule; TRD, treatment-resistant depression; “–” data not provide.