Deep Brain Stimulation for Depression Informed by Intracranial Recordings

Sheth, Sameer A.; Bijanki, Kelly R.; Metzger, Brian; Allawala, Anusha; Pirtle, Victoria; Adkinson, Josh A.; Myers, John; Mathura, Raissa; Oswalt, Denise; Tsolaki, Evangelia; Xiao, Jiayang; Noecker, Angela M.; Strutt, Adriana M.; Cohn, Jeffrey F.; McIntyre, Cameron C.; Mathew, Sanjay J.; Borton, David A.; Goodman, Wayne K.; Pouratian, Nader

doi:10.1016/j.biopsych.2021.11.007

Cited by 78 publications

(54 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We assayed changes in depression severity while simultaneously recording from the implanted electrodes. Clinical outcomes from the first subject in this trial have recently been reported 23 . Here we report neural modeling results and include two additional subjects.…”

Section: Resultsmentioning

confidence: 99%

“…These studies have described various alterations in brain activity patterns and suggested potential biomarkers, but precise neurophysiological understanding is still lacking 21 . This understanding, drilled down to the level of the individual, will be essential for treatment-resistant patients being considered for invasive neuromodulation such as deep brain stimulation (DBS) 6,22,23 .…”

Section: Main Textmentioning

confidence: 99%

“…In our trial, three patients with severe TRD who met eligibility criteria and provided informed consent were implanted with two sets of intracranial electrodes during an initial surgery, one set primarily for stimulating and the other primarily for recording 6,27 (Fig. 1).…”

Section: Spectral Activity Across Prefrontal Regions Correlates With ...mentioning

confidence: 99%

“…Four DBS leads (Cartesia, Boston Scientific) were placed bilaterally in the ventral capsule/ventral striatum (VC/VS) and subcallosal cingulate (SCC) as previously described 27 . Ten stereoelectroencephalography (sEEG) electrodes were placed bilaterally in depression-relevant brain regions including anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (dlPFC), orbitofrontal cortex (OFC), and ventromedial prefrontal cortex (vmPFC).…”

Section: Implant Surgerymentioning

confidence: 99%

See 3 more Smart Citations

Decoding Depression Severity from Intracranial Neural Activity

Xiao

Provenza

Asfouri

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Disorders of mood and cognition are prevalent, disabling, and notoriously difficult to treat. Fueling this challenge in treatment is a significant gap in our understanding of their neurophysiological basis. Here, we used intracranial neural recordings in three patients with severe depression to investigate the neural substrates of this disorder. Across prefrontal regions, we found that reduced depression severity is associated with decreased low-frequency neural activity and increased high-frequency activity. When constraining our model to decode using a single region, spectral changes in the anterior cingulate cortex best predicted depression severity in all three subjects. Relaxing this constraint revealed unique, individual-specific sets of spatio-spectral features predictive of symptom severity, reflecting the heterogeneous nature of depression. The ability to decode depression severity from neural activity increases our fundamental understanding of how depression manifests in the human brain and provides a target neural signature for personalized neuromodulation therapies.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

Section: Spectral Activity Across Prefrontal Regions Correlates With ...mentioning

confidence: 99%

Section: Implant Surgerymentioning

confidence: 99%

See 2 more Smart Citations

Decoding Depression Severity from Intracranial Neural Activity

Xiao

Provenza

Asfouri

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Details of neuroimaging are provided previously [14,15]. T1-weighted anatomical imaging (MPRAGE; 1mm isotropic, TR/TE/TI=2400/2.24/1160; FOV=256; 208 slices; flip angle=8º) and Diffusion weighted imaging data (DWI) were acquired prior to surgical implantation of DBS.…”

Section: Methodsmentioning

confidence: 99%

Automated optimization of deep brain stimulation parameters for modulating neuroimaging-based targets

Malekmohammadi

Mustakos

Sheth

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

ObjectiveTherapeutic efficacy of deep brain stimulation (DBS) in both established and emerging indications, is highly dependent on accurate lead placement and optimized clinical programming. The latter relies on clinicians’ experience to search among available sets of stimulation parameters and can be limited by the time constraints of clinical practice. Recent innovations in device technology have expanded the number of possible electrode configurations and parameter sets available to clinicians, amplifying the challenge of time constraints. We hypothesize that patient specific neuroimaging data which can effectively assist the clinical programming using automated algorithms.ApproachThis paper introduces the DBS Illumina 3D algorithm as a tool which uses patient-specific imaging to find stimulation settings that optimizes activating a target area while minimizing the stimulation of areas outside the target that could result in unknown or undesired side effects. This approach utilizes preoperative neuroimaging data paired with the postoperative reconstruction of lead trajectory to search the available stimulation space and identify optimized stimulation parameters. We describe the application of this algorithm in three patients with treatment-resistant depression who underwent bilateral implantation of DBS in subcallosal cingulate cortex (SCC) and ventral capsule/ventral striatum (VC/VS) using tractography optimized targeting with an imaging defined target previously described.Main resultsCompared to the stimulation settings selected by the clinicians (informed by anatomy), stimulation settings produced by the algorithm achieved similar or greater target coverage, while producing a significantly smaller stimulation area that spills outside the target (P=0.002).SignificanceThe DBS Illumina 3D algorithm is seamlessly integrated with the clinician programmer software and effectively and rapidly assists clinicians with the analysis of image based anatomy, and provides a starting point for the clinicians to search the highly complex stimulation parameter space and arrive at the stimulation settings that optimize activating a target area.Clinical trial registration number: NCT 03437928

show abstract

What Ethical Issues Need to Be Considered When Doing Research with Patients Undergoing Invasive Electrode Implantation?

Feinsinger

Pouratian

2023

Studies in Neuroscience, Psychology and Behavioral Economics

View full text Add to dashboard Cite

Deep Brain Stimulation for Depression Informed by Intracranial Recordings

Cited by 78 publications

References 28 publications

Decoding Depression Severity from Intracranial Neural Activity

Decoding Depression Severity from Intracranial Neural Activity

Automated optimization of deep brain stimulation parameters for modulating neuroimaging-based targets

What Ethical Issues Need to Be Considered When Doing Research with Patients Undergoing Invasive Electrode Implantation?

Contact Info

Product

Resources

About