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Türk Nöroşirürji Dergisi 2014 , Vol 24 , Num 2

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Surgical Treatments for Depression

Yasin TEMEL¹, Ersoy KOCABIÇAK^1,2

¹Maastricht Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Maastricht, Hollanda
²Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Samsun, Türkiye The neurosurgical treatment of treatment-resistant depression (TRD) has entered a new era with more and more patients being treated with deep brain stimulation (DBS) via surgically implanted intracerebral electrodes. Although the mechanisms of action of DBS are still not fully understood, preclinical studies are being conducted to elucidate how the treatment might work. DBS in its present form can be considered as a relatively new neurosurgical treatment for TRD. However, the use of neurosurgery in the management of depression has a much longer history, particularly with ablative procedures but also with vagal nerve stimulation.

Here, we provide a review of the clinical neurosurgical treatments for TRD, with the main emphasis on DBS. In addition, we discuss relevant preclinical data that are revealing new information about DBS mechanisms. Anahtar Kelimeler : Treatment resistant depression, Neurosurgery, Ablative surgery, Vagal nerve stimulation, Deep brain stimulation