Practical Considerations in the Development and Refinement of Subcallosal Cingulate White Matter Deep Brain Stimulation for Treatment-Resistant Depression.

Background: Deep brain stimulation has been investigated in the past decade as a viable intervention for treatment-resistant depression. Methods: Several anatomic targets have been tested, with the most extensive published experience found for the subcallosal cingulate (SCC) white matter. Results: This article reviews the current state of clinical research of SCC deep brain stimulation for treatment-resistant depression, including an overview of the rationale for targeting SCC, practical considerations for subject recruitment and evaluation, surgical planning, and stimulation parameters. Conclusion: Clinical management of patients in the initial and long-term naturalistic phases of treatment, including the potential role for psychotherapeutic rehabilitation, is discussed. [Copyright &y& Elsevier]