Deep Brain Stimulation Yields Improvements in Refractory Depression

FRIDAY, Nov. 21, 2025 (HealthDay News) — Deep brain stimulation (DBS) in the bed nucleus of the stria terminalis (BNST) yields improvements for some patients with refractory depression, according to a study published online Nov. 18 in Nature Communications.

Linbin Wang, from Shanghai Jiao Tong University School of Medicine, and colleagues conducted a randomized trial of DBS of the BNST, an extended amygdala structure, and nucleus accumbens (NAc) in 26 patients with refractory depression.

The researchers found that in the open-label phase, BNST-NAc DBS yielded a 50 percent depression response rate and a 35 percent remission rate. Using acute and chronic intracranial recordings, machine learning, and an integrated framework combining electrophysiology, neuroimaging, and behavior, an objective intracranial physiological biomarker was identified: After chronic stimulation at three, six, and 12 months, lower BNST theta and prefrontal-BNST coherence with top-down connectivity predicted better depression outcomes and quality of life; this finding was confirmed across eyes-open and eyes-closed states and machine learning. A physiology-guided connectivity network involving dorsal anterior cingulate and lateral inferior frontal cortex tracts was identified.

“We found that brain activity at a particular frequency — theta brainwaves — could tell us which patients would have the best response to DBS treatment in the BNST brain region,” Wang said in a statement. “This could help us personalize treatment for individual patients in [the] future.”

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