Evolving refractory major depressive disorder diagnostic and treatment paradigms: toward closed-loop therapeutics.

Frontiers in Neuroengineering
Matthew P Ward, Pedro P Irazoqui

Abstract

Current antidepressant therapies do not effectively control or cure depressive symptoms. Pharmaceutical therapies altogether fail to address an estimated 4 million Americans who suffer from a recurrent and severe treatment-resistant form of depression known as refractory major depressive disorder. Subjective diagnostic schemes, differing manifestations of the disorder, and antidepressant treatments with limited theoretical bases each contribute to the general lack of therapeutic efficacy and differing levels of treatment resistance in the refractory population. Stimulation-based therapies, such as vagus nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation, are promising treatment alternatives for this treatment-resistant subset of patients, but are plagued with inconsistent reports of efficacy and variable side effects. Many of these problems stem from the unknown mechanisms of depressive disorder pathogenesis, which prevents the development of treatments that target the specific underlying causes of the disorder. Other problems likely arise due to the non-specific stimulation of various limbic and paralimbic structures in an open-loop configuration. This review critically assesses current literature...Continue Reading

Citations

Nov 16, 2012·Medical Devices : Evidence and Research·Khalid Saad Al-Harbi, Naseem Akhtar Qureshi
Jun 2, 2012·Patient Preference and Adherence·Khalid Saad Al-Harbi
May 23, 2014·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Felice T Sun, Martha J Morrell
Sep 19, 2014·Journal of Affective Disorders·Lan-Ying LiuZhang-Jin Zhang
Jul 31, 2013·Journal of Affective Disorders·Chris BaekenRudi De Raedt
Mar 13, 2014·Journal of Neural Engineering·Alik S Widge, Chet T Moritz
Nov 16, 2018·Frontiers in Psychology·Chris Baeken
Sep 5, 2019·Frontiers in Neuroscience·Khalid B MirzaChristofer Toumazou
Sep 25, 2021·Journal of Molecular Modeling·Genisson R SantosAlbérico B F da Silva

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Methods Mentioned

BETA
biosensors
ELISA
enzyme-linked immunosorbent assay
biosensing

Software Mentioned

NeuroStar

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