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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: [email protected]
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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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References

Bagby, RM, Quilty, LC and Ryder, AC (2008) Personality and depression. The Canadian Journal of Psychiatry 53, 14–25.Google Scholar
Bagby, RM, Rector, NA, Bindseil, K, Dickens, SE, Levitan, RD and Kennedy, SH (1998) Self-report ratings and informants’ ratings of personalities of depressed outpatients. American Journal of Psychiatry 155, 437–438.Google Scholar
Bewernick, BH, Hurlemann, R, Matusch, A, Kayser, S, Grubert, C, Hadrysiewicz, B et al. (2010) Nucleus accumbens deep brain stimulation decreases ratings of depression and anxiety in treatment-resistant depression. Biological Psychiatry 67, 110–116.Google Scholar
Bewernick, BH, Kayser, S, Gippert, SM, Coenen, VA and Schlaepfer, TE (2017 a) Acute antidepressant effects of deep brain stimulation – review and data from slMFB-stimulation. Personalized Medicine in Psychiatry 3, 1–7.Google Scholar
Bewernick, BH, Kayser, S, Gippert, SM, Switala, C, Coenen, VA and Schlaepfer, TE (2017 b) Deep brain stimulation to the medial forebrain bundle for depression-long-term outcomes and a novel data analysis strategy. Brain Stimulation 10, 664–671.Google Scholar
Bewernick, BH, Kayser, S, Sturm, V and Schlaepfer, TE (2012) Long-term effects of nucleus accumbens deep brain stimulation in treatment-resistant depression: evidence for sustained efficacy. Neuropsychopharmacology 37, 1975.Google Scholar
Borkenau, P and Ostendorf, F (2008) NEO-FFI: NEO-Fünf-Faktoren-Inventar nach Costa und McCrae, Manual. 2nd ed. Göttingen: Hogrefe.Google Scholar
Chioqueta, AP and Stiles, TC (2005) Personality traits and the development of depression, hopelessness, and suicide ideation. Personality and Individual Differences 38, 1283–1291.Google Scholar
Coenen, VA, Panksepp, J, Hurwitz, TA, Urbach, H and Mädler, B (2012) Human medial forebrain bundle (MFB) and anterior thalamic radiation (ATR): imaging of two major subcortical pathways and the dynamic balance of opposite affects in understanding depression. The Journal of Neuropsychiatry and Clinical Neurosciences 24, 223–236.Google Scholar
Connolly, JJ, Kavanagh, EJ and Viswesvaran, C (2007) The convergent validity between self and observer ratings of personality: a meta-analytic review. International Journal of Selection and Assessment 15, 110–117.Google Scholar
Corruble, E, Duret, C, Pelissolo, A, Falissard, B and Guelfi, JD (2002) Early and delayed personality changes associated with depression recovery? A one-year follow-up study. Psychiatry Research 109, 17–25.Google Scholar
Costa, PT, Bagby, RM, Herbst, JH and McCrae, RR (2005) Personality self-reports are concurrently reliable and valid during acute depressive episodes. Journal of Affective Disorders 89, 45–55.Google Scholar
Cuijpers, P, van Straten, A and Donker, M (2005) Personality traits of patients with mood and anxiety disorders. Psychiatry Research 133, 229–237.Google Scholar
De Fruyt, F, Van Leeuwen, K, Bagby, RM, Rolland, J-P and Rouillon, F (2006) Assessing and interpreting personality change and continuity in patients treated for major depression. Psychological Assessment 18, 71.Google Scholar
DeYoung, CG (2013) The neuromodulator of exploration: a unifying theory of the role of dopamine in personality. Frontiers in Human Neuroscience 7, 1–26.Google Scholar
Du, L, Bakish, D, Ravindran, AV and Hrdina, PD (2002) Does fluoxetine influence major depression by modifying five-factor personality traits? Journal of Affective Disorders 71, 235–241.Google Scholar
Fava, M (2003) Diagnosis and definition of treatment-resistant depression. Biological Psychiatry 53, 649–659.Google Scholar
Fergusson, DM, Woodward, LJ and Horwood, LJ (2000) Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychological Medicine 30, 23–39.Google Scholar
Glannon, W (2009) Stimulating brains, altering minds. Journal of Medical Ethics 35, 289–292.Google Scholar
Hamilton, M (1960) A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 56.Google Scholar
Huys, D, Bartsch, C, Koester, P, Lenartz, D, Maarouf, M, Daumann, J et al. (2016) Motor improvement and emotional stabilization in patients with Tourette syndrome after deep brain stimulation of the ventral anterior and ventrolateral motor part of the thalamus. Biological Psychiatry 79, 392–401.Google Scholar
Jylhä, P and Isometsä, E (2006) The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population. Depression and Anxiety 23, 281–289.Google Scholar
Karsten, J, Penninx, BW, Riese, H, Ormel, J, Nolen, WA and Hartman, CA (2012) The state effect of depressive and anxiety disorders on big five personality traits. Journal of Psychiatric Research 46, 644–650.Google Scholar
Klein, DN, Kotov, R and Bufferd, SJ (2011) Personality and depression: explanatory models and review of the evidence. Annual Review of Clinical Psychology 7, 269–295.Google Scholar
Kotov, R, Gamez, W, Schmidt, F and Watson, D (2010) Linking ‘big’ personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychological Bulletin 136, 768–821.Google Scholar
Lewinsohn, PM (1974) A behavioral approach to depression. In Coyne JC (ed.). Essential Papers on Depression. New York: New York University Press, pp. 150–180.Google Scholar
Lozano, AM, Mayberg, HS, Giacobbe, P, Hamani, C, Craddock, RC and Kennedy, SH (2008) Subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression. Biological Psychiatry 64, 461–467.Google Scholar
Malone, DA, Dougherty, DD, Rezai, AR, Carpenter, LL, Friehs, GM, Eskandar, EN et al. (2009) Deep brain stimulation of the ventral capsule/ventral striatum for treatment-resistant depression. Biological Psychiatry 65, 267–275.Google Scholar
Mayring, P (2010) Qualitative inhaltsanalyse. In Mey G & Mruck K (eds). Handbuch Qualitative Forschung in der Psychologie. Wiesbaden: Springer, pp. 601–613.Google Scholar
McCrae, RR, Costa, PT, Hr̆ebíc̆ková, M, Urbánek, T, Martin, TA, Oryol, VE et al. (2004) Age differences in personality traits across cultures: self-report and observer perspectives. European Journal of Personality 18, 143–157.Google Scholar
McGirr, A, Van den Eynde, F, Chachamovich, E, Fleck, MP and Berlim, MT (2014) Personality dimensions and deep repetitive transcranial magnetic stimulation (DTMS) for treatment-resistant depression: a pilot trial on five-factor prediction of antidepressant response. Neuroscience Letters 563, 144–148.Google Scholar
Montgomery, SA and Asberg, M (1979) A new depression scale designed to be sensitive to change. The British Journal of Psychiatry 134, 382–389.Google Scholar
Morey, LC, Shea, MT, Markowitz, JC, Stout, RL, Hopwood, CJ, Gunderson, JG et al. (2010) State effects of major depression on the assessment of personality and personality disorder. American Journal of Psychiatry 167, 528–535.Google Scholar
Petersen, T, Bottonari, K, Alpert, JE, Fava, M and Nierenberg, AA (2001) Use of the five-factory inventory in characterizing patients with major depressive disorder. Comprehensive Psychiatry 42, 488–493.Google Scholar
Pham, U, Solbakk, AK, Skogseid, IM, Toft, M, Pripp, AH, Konglund, AE et al. (2015) Personality changes after deep brain stimulation in Parkinson's disease. Parkinson's Disease 2015, 490507.Google Scholar
Riemann, R, Angleitner, A and Strelau, J (1997) Genetic and environmental influences on personality: a study of twins reared together using the self-and peer report NEO-FFI scales. Journal of Personality 65, 449–475.Google Scholar
Rush, AJ, Trivedi, MH, Wisniewski, SR, Nierenberg, AA, Stewart, JW, Warden, D et al. (2006) Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR* D report. American Journal of Psychiatry 163, 1905–1917.Google Scholar
Sackeim, HA (2001) The definition and meaning of treatment-resistant depression. Journal of Clinical Psychiatry 62, 10–17.Google Scholar
Schermer, M (2011) Ethical issues in deep brain stimulation. Frontiers in Integrative Neuroscience 5, 1–5.Google Scholar
Schlaepfer, TE, Bewernick, BH, Kayser, S, Mädler, B and Coenen, VA (2013) Rapid effects of deep brain stimulation for treatment-resistant major depression. Biological Psychiatry 73, 1204–1212.Google Scholar
Schüpbach, M, Gargiulo, M, Welter, M, Mallet, L, Béhar, C, Houeto, J-L et al. (2006) Neurosurgery in Parkinson disease A distressed mind in a repaired body? Neurology 66, 1811–1816.Google Scholar
Synofzik, M and Schlaepfer, TE (2008) Stimulating personality: ethical criteria for deep brain stimulation in psychiatric patients and for enhancement purposes. Biotechnology Journal 3, 1511–1520.Google Scholar
Takahashi, M, Shirayama, Y, Muneoka, K, Suzuki, M, Sato, K and Hashimoto, K (2013) Low openness on the revised NEO personality inventory as a risk factor for treatment-resistant depression. PLoS ONE 8, e71964.Google Scholar
Tang, TZ, DeRubeis, RJ, Hollon, SD, Amsterdam, J, Shelton, R and Schalet, B (2009) Personality change during depression treatment: a placebo-controlled trial. Archives of General Psychiatry 66, 1322–1330.Google Scholar