Bed nucleus of the stria terminalis-nucleus accumbens stimulation for depression: A randomized, double-blind, crossover trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Although deep brain stimulation (DBS) shows potential in treatment-resistant depression (TRD), the efficacy remains controversial. To assess the efficacy of DBS of the bed nucleus of the stria terminalis (BNST) and nucleus accumbens (NAc) for TRD, we conduct a randomized, double-blind, crossover trial after an open-label optimization stage. Stimulation leads to a mean decrease in the Hamilton Depression Scale-17 (HAMD) scores of 10.1 points (p < 0.001) with a 50% response rate at the end of the open-label stage. Anxiety, quality of life, and disability are also improved. The HAMD scores are significantly lower in patients during active DBS than during sham DBS (p < 0.001). Serious adverse events include suicide (1 patient) and seizure (1 patients). With individual stimulation analysis, we identify optimal stimulation sites, fiber tracts, and functional networks (false discovery rate [FDR] p < 0.05). This study demonstrates the efficacy and safety of BNST-NAc DBS for TRD and reveals optimal brain targets for stimulation. This study was registered at ClinicalTrials.gov (NCT04530942).
Source: Cell Reports Medicine
Authors: Yijie Lai, Yingying Zhang, Yuhan Wang, Linbin Wang, Luling Dai, Kuanghao Ye, Xin Lv, Fengting Wang, Jinrong Zhang, Yijie Zhao, Kejia Hu, Peng Huang, Xiaoxiao Zhang, Xian Qiu, Yixin Pan, Wei Liu, Qimin Liu, Chencheng Zhang, Yiru Fang, Zheng Ye, Ti-Fei Yuan, Dianyou Li, Ningfei Li, Andres M. Lozano, Valerie Voon, Shikun Zhan, Bomin Sun
Institutions: Shanghai Jiao Tong University, Ruijin Hospital, Fudan University, University of Cambridge, Sir Run Run Shaw Hospital, Zhejiang University, Boston University, Shanghai Mental Health Center, Shanghai Key Laboratory of Psychotic Disorders, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, University Health Network, University of Toronto, Krembil Research Institute
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $5,620
Funders: National Natural Science Foundation of China, Science and Technology Commission of Shanghai Municipality, Shanghai Jiao Tong University, National University's Basic Research Foundation of China, SceneRay, Medical Research Council, Fundamental Research Funds for the Central Universities, Scientific and Innovative Action Plan of Shanghai
OpenAlex ID: W7144324646