Isidoor Bergfeld

• Ph.D.
• Researcher at Amsterdam UMC; University of Amsterdam

Importance: Patients with treatment-resistant depression (TRD) do not respond sufficiently to several consecutive treatments for major depressive disorder. Deep brain stimulation (DBS) is a promising treatment for these patients, but presently placebo effects cannot be ruled out. Objective: To assess the efficacy of DBS of the ventral anterior l...

Background Electroconvulsive Therapy (ECT) and Deep Brain Stimulation (DBS) are effective treatments for patients with treatment-resistant depression (TRD). However, a common side effect of ECT is autobiographical memory loss (e.g., personal experiences), whereas the impact of DBS on autobiographical memories has never been established. Objective...

Background: Thirty percent of patients with treatment-resistant depression (TRD) attempt suicide at least once during their lifetime. However, it is unclear what the attempted and completed suicide incidences are in TRD patients after initiating a treatment, and whether specific treatments increase or decrease these incidences. Methods: We searc...

Objective Deep brain stimulation (DBS) reduces depressive symptoms in approximately 40%–60% of patients with treatment-resistant depression (TRD), but data on long-term efficacy and safety are scarce. Our objective was to assess the efficacy and safety of DBS targeted at the ventral anterior limb of the internal capsule (vALIC) in 25 patients with...

Treatment-resistant depression (TRD) is a debilitating condition associated with higher medical costs, increased illness burden, and reduced quality of life compared to non-treatment-resistant major depressive disorder (MDD). The question arises whether TRD can be considered a distinct MDD sub-type based on neurobiological features. To answer this...

Objective Deep brain stimulation (DBS) targeting the ventral anterior limb of the internal capsule (vALIC) shows potential as treatment for treatment resistant depression (TRD). While DBS alters brain function, it is not yet known whether it also induces anatomical alterations. Here we investigated the long-term effects of vALIC DBS on brain struct...

Introduction Assessment of autobiographical memory following electroconvulsive therapy is lacking multilingual options. We therefore developed the Dutch translation of the Columbia University Autobiographical Memory Interview—Short Form (CUAMI-SF). We aimed to assess its practical use and identify segments for potential revision to improve the inte...

Deep brain stimulation (DBS) reduces depressive symptom scores in many patients with treatment-resistant depression (TRD). However, it is unclear whether the observed improvement is similar across various symptom dimensions (e.g., anhedonia, anxiety, insomnia) or if some require additional clinical attention. Using a retrospective chart review, we...

Depression is associated with abnormal functioning of the reward circuitry. Several deep brain stimulation (DBS) targets for treatment-resistant depression (TRD) directly modulate white matter bundles of the reward circuitry. Here we investigated whether baseline reward processing in the brain is associated with ventral anterior limb of the interna...

Background Major depressive disorder and bipolar depression in adolescents and young adults are prevalent and major contributors to the global burden of disease, whereas effective interventions are limited. Available evidence is insufficient to assess effectiveness and tolerability of electroconvulsive therapy in depressed adolescents and young adu...

Deep brain stimulation (DBS) is a promising intervention for treatment-resistant depression (TRD). Effects on cognitive functioning are unclear since they have been studied in small samples. We aim to estimate the impact of DBS on cognitive functioning in TRD with a systematic review and meta-analyses. After systematically searching PubMed we inclu...

Background This study aims: (1) To compare cognitive and psychiatric outcomes after bilateral awake versus asleep subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for Parkinson’s disease (PD). (2) To explore the occurrence of psychiatric diagnoses, cognitive impairment and quality of life after surgery in our whole sample. (3) To vali...

Deep brain stimulation (DBS) is being investigated as treatment for patients with refractory major depressive disorder (MDD). However, little is known about how DBS exerts its antidepressive effects.Here, we investigated whether ventral anterior limb of the internal capsule (vALIC) stimulation modulates a limbic network centered around the amygdala...

Deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule (vALIC) is a promising intervention for treatment-resistant depression (TRD). However, the working mechanisms of vALIC DBS in TRD remain largely unexplored. As major depressive disorder has been associated with aberrant amygdala functioning, we investigated whether vA...

Objective. Deep brain stimulation is a treatment option for patients with refractory obsessive-compulsive disorder. A new generation of stimulators hold promise for closed loop stimulation, with adaptive stimulation in response to biologic signals. Here we aimed to discover a suitable biomarker in the ventral striatum in patients with obsessive com...

Background: Deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule (vALIC) is effective for refractory obsessive-compulsive disorder (OCD), but patients typically require high stimulation voltages and DBS comes with a risk for adverse events (AE). Objective: The aim of the present study was to advance DBS for OCD by op...

Deep brain stimulation (DBS) is a promising intervention for treatment-resistant depression (TRD). Effects on cognitive functioningare unclear since they have been studied in small samples. We aim to estimate the impact of DBS on cognitive functioning in TRDwith a systematic review and meta-analyses. After systematically searching PubMed we include...

Introduction: Deep brain stimulation (DBS) is an effective treatment for treatment-refractory obsessive-compulsive disorder (OCD) and is currently being studied in several other psychiatric disorders [2]. Although it’s established effect in the treatment of OCD [1] and promising preliminary findings in other psychiatric disorders patients eligible...

Deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule (vALIC) is a promising intervention for treatment-resistant depression (TRD). However, the working mechanisms of vALIC DBS in TRD remain largely unexplored. As major depressive disorder has been associated with aberrant amygdala functioning, we investigated whether vA...

Deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule (vALIC) is effective for refractory obsessive-compulsive disorder (OCD). Retrospective evaluation showed that stimulation closer to the supero-lateral branch of the medial forebrain bundle (slMFB), within the vALIC, was associated with better response to DBS. The pres...

Background: Given the invasiveness of deep brain stimulation (DBS), the effect should prove to be stable over the long-term and translate into an improvement of quality of life (QOL). Objective: To study the effectiveness and QOL up to nine years after the DBS surgery. Methods: We treated 25 adult patients with major depression with DBS of the...

Introduction: Major depressive disorder (MDD) affects 163 million people globally every year. Individuals who experience subsyndromal depressive symptoms during remission (ie, partial remission of MDD) are especially at risk for a return to a depressive episode within an average of 4 months. Simultaneously, partial remission of MDD is associated w...

Background: Our aim was to examine long-term effectiveness and tolerability of DBS in treatment-refractory obsessive-compulsive disorder (OCD), depression and anorexia nervosa. Moreover, we investigated factors that could predict treatment response and compare to meta-analytical outcomes. Methods: From our worldwide largest cohort of treatment-ref...

Background: A new generation of deep brain stimulation (DBS) stimulators hold promise for closed loop stimulation, with personalized adaptive stimulation in response to biological signals. This approach requires network biomarkers that indicate when stimulation is needed. We present data on intracranial and extracranial electrophysiological recordi...

Background: Deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule (vALIC) is a promising intervention for treatment-resistant major depressive disorder (MDD). Depression has been associated with aberrant amygdala responsivity to emotional stimuli. We therefore tested whether vALIC DBS could normalize amygdala responsivit...

Deep brain stimulation (DBS) targeted to several brain areas has shown considerable promise in treating treatment-resistant depression with 40-60% of patients improving after one year of treatment. Because in virtually all included patients white matter was stimulated, several research groups started imaging white matter tracts to investigate wheth...

Introduction: Recent evidence for refractory obsessive compulsive disorder (OCD) showed that response in vALIC-DBS is associated with active stimulation closer to the supero-lateral branch of the medial forebrain bundle (MFB). In the present study, we compared results of diffusion tensor imaging (DTI) fiber tractographically (FT)-assisted MFB-DBS t...

Deep brain stimulation is a treatment option for patients with refractory obsessive-compulsive disorder. A new generation of stimulators hold promise for closed loop stimulation, with adaptive stimulation in response to biological signals Here we aimed to discover a suitable biomarker in the ventral striatum in patients with obsessive compulsive di...

It becomes increasingly clear that (non-)invasive neurostimulation is an effective treatment for obsessive-compulsive disorder (OCD). In this chapter we review the available evidence on techniques and targets, clinical results including a meta-analysis, mechanisms of action, and animal research. We focus on deep brain stimulation (DBS), but also co...

Objective Ablative surgery (ABL) and deep brain stimulation (DBS) are last‐resort treatment options for patients suffering from treatment‐refractory obsessive‐compulsive disorder (OCD). The aim of this study was to conduct an updated meta‐analysis comparing the clinical outcomes of the ablative procedures capsulotomy and cingulotomy and deep brain...

This the Dutch translation of the Columbia University - Autobiographical Memory Interview, Short From (CU-AMI-SF), orginally authored by Martin McElhiney, Bobba Moody and Harold Sackeim. It contains the manual and forms for recording and scoring the interview. This interview is intended to quantify retrograde amnesia following electroconvulsive th...

Background Patients with misophonia suffer from anger or disgust confronted with specific sounds such as smacking or breathing. Avoidance of cue‐related situations results in social isolation and significant functional impairment. This is the first randomized, controlled cognitive behavioral therapy (CBT) trial for misophonia, evaluating the short‐...

Apathy, the loss of motivation, is a common problem in Parkinson's disease (PD) and often observed following deep brain stimulation (DBS) of the subthalamic nucleus (STN). The aim of this meta‐analysis was to determine the occurrence of apathy following STN DBS in literature. Relevant articles were searched in PubMed/Medline, SCOPUS, EMBASE, and We...

Objectives Deep brain stimulation (DBS) is an innovative and effective treatment for patients with therapy‐refractory obsessive–compulsive disorder (OCD). DBS offers unique opportunities for personalized care, but no guidelines on how to choose effective and safe stimulation parameters in patients with OCD are available. Our group gained relevant p...

Background Deep brain stimulation (DBS) is an innovative treatment for treatment-refractory depression. DBS is usually targeted at specific anatomical landmarks, with patients responding to DBS in approximately 50% of cases. Attention has recently shifted to white matter tracts to explain DBS response, with initial open-label trials targeting white...

Open-label studies of deep brain stimulation (DBS) for patients with treatment-resistant depression (TRD) are promising: approximately 40% of patients lose at least half of their symptoms following DBS of the subcallosal cingulate cortex (SCC) or ventral capsule and ventral striatum (VC/VS). The results of sham-controlled trials, however, have been...

This is a comment on the paper of Ramasubbu et al (Lancet Psychiatry, 2020), in which they randomized patients to deep brain stimulation with a short or a long pulse width.

Objective: Deep brain stimulation (DBS) is an innovative treatment for treatment-resistant depression. DBS is usually targeted at specific anatomical landmarks, with patients responding to DBS in approximately 50% of cases. Attention has recently shifted to white matter tracts to explain DBS response, with initial open-label trials targeting white...

Background: Deep Brain Stimulation (DBS) is effective for obsessive-compulsive disorder (OCD), but requires expensive medical procedures. To date, no study has examined the cost-effectiveness of DBS for OCD. Objective: To perform the first economic evaluation of DBS for therapy refractory OCD. Methods: We conducted a 2-year prospective, open c...

Background: Deep Brain Stimulation (DBS) is a promising treatment for patients with Treatment Resistant Depression (TRD). Preliminary neuropsychological studies also show DBS does not affect cognitive functions of TRD patients and might even have a cognitive enhancing effect. However, practice effects could not be ruled out in these studies and act...

Background Preliminary studies report no negative and a possible positive impact of deep brain stimulation (DBS) on cognition of patients with treatment-resistant depression (TRD). However, these studies neither controlled for practice effects nor compared active with sham stimulation. Method To address these limitations, we compared 25 TRD patien...

Cost-effectiveness of deep brain stimulation versus treatment as usual for obsessive-compulsive disorder

Poster abstract of results published in JAMA Psychiatry (2016), 73(5):456-464. https://doi.org/10.1001/jamapsychiatry.2016.0152

Preliminary analysis on the impact of deep brain stimulation on autobiographical memory compared to electroconvulsive therapy.