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Deep brain stimulation of the supero-lateral branch of the medial forebrain bundle does not lead to changes in personality in patients suffering from severe depression

Published online by Cambridge University Press:  01 March 2018

Bettina H. Bewernick ,
Hannah M. Kilian ,
Klaudius Schmidt ,
Ruth E. Reinfeldt ,
Sarah Kayser ,
Volker A. Coenen ,
Sebastian Markett  and
Thomas E. Schlaepfer
Bettina H. Bewernick
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany Division of Interventional Biological Psychiatry, University Hospital Freiburg, Germany Department of Neurodegenerative Diseases and Geronto Psychiatry, University Hospital Bonn, Germany
Hannah M. Kilian
Affiliation:
Division of Interventional Biological Psychiatry, University Hospital Freiburg, Germany
Klaudius Schmidt
Affiliation:
Department of General Psychology I, University of Cologne, Germany
Ruth E. Reinfeldt
Affiliation:
Department of Neurodegenerative Diseases and Geronto Psychiatry, University Hospital Bonn, Germany
Sarah Kayser
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Mainz, Germany
Volker A. Coenen
Affiliation:
Department of Stereotactic and Functional Neurosurgery, University Hospital Freiburg, Germany
Sebastian Markett
Affiliation:
Department of Biological Psychology, University of Bonn, Germany Department of Psychology, Humbold-University of Berlin, Germany
Thomas E. Schlaepfer*
Affiliation:
Division of Interventional Biological Psychiatry, University Hospital Freiburg, Germany Departments of Psychiatry and Mental Health, The Johns Hopkins University, Baltimore, Maryland, USA
*
Author for correspondence: Thomas E. Schlaepfer, E-mail: schlaepf@jhmi.edu
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Abstract

Background

Reports of changes in patients’ social behavior during deep brain stimulation (DBS) raised the question whether DBS induces changes in personality. This study explored if (1) DBS is associated with changes in personality in patients suffering from treatment-resistant depression (TRD), (2) how personality dimensions and depression are associated, and (3) if TRD patients’ self-ratings of personality are valid.

Methods

TRD patients were assessed before DBS (n = 30), 6 months (t2, n = 21), 2 (t3, n = 17) and 5 years (t4, n = 11) after the initiation of DBS of the supero-lateral branch of the medial forebrain bundle (slMFB-DBS). Personality was measured with the NEO-Five-Factor Inventory (NEO-FFI), depression severity with Hamilton (HDRS), and Montgomery–Åsberg Depression Rating Scale (MADRS).

Results

Personality dimensions did not change with slMFB-DBS compared with baseline. Extraversion was negatively correlated with HDRS28 (r = −0.48, p < 0.05) and MADRS (r = −0.45, p < 0.05) at t2. Inter-rater reliability was high for the NEO-FFI at baseline (Cronbach's α = 0.74) and at t4 (α = 0.65). Extraversion [t(29) = −5.20; p < 0.001] and openness to experience [t(29) = −6.96; p < 0.001] differed statistically significant from the normative sample, and did not predict the antidepressant response.

Conclusions

slMFB-DBS was not associated with a change in personality. The severity of depression was associated with extraversion. Personality of TRD patients differed from the healthy population and did not change with response, indicating a possible scar effect. Self-ratings of personality seem valid to assess personality during TRD.

Keywords

Deep brain stimulationNEO-FFIpersonalitysupero-lateral branch of the medial forebrain bundletreatment-resistant depression
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 16 , December 2018 , pp. 2684 - 2692
Copyright
Copyright © Cambridge University Press 2018 

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