1
|
Robertson RV, Meylakh N, Crawford LS, Tinoco Mendoza FA, Macey PM, Macefield VG, Keay KA, Henderson LA. Differential activation of lateral parabrachial nuclei and their limbic projections during head compared with body pain: A 7-Tesla functional magnetic resonance imaging study. Neuroimage 2024; 299:120832. [PMID: 39236852 DOI: 10.1016/j.neuroimage.2024.120832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/16/2024] [Accepted: 09/02/2024] [Indexed: 09/07/2024] Open
Abstract
Pain is a complex experience that involves sensory, emotional, and motivational components. It has been suggested that pain arising from the head and orofacial regions evokes stronger emotional responses than pain from the body. Indeed, recent work in rodents reports different patterns of activation in ascending pain pathways during noxious stimulation of the skin of the face when compared to noxious stimulation of the body. Such differences may dictate different activation patterns in higher brain regions, specifically in those areas processing the affective component of pain. We aimed to use ultra-high field functional magnetic resonance imaging (fMRI at 7-Tesla) to determine whether noxious thermal stimuli applied to the surface of the face and body evoke differential activation patterns within the ascending pain pathway in awake humans (n=16). Compared to the body, noxious heat stimulation to the face evoked more widespread signal changes in prefrontal cortical regions and numerous brainstem and subcortical limbic areas. Moreover, facial pain evoked significantly different signal changes in the lateral parabrachial nucleus, substantia nigra, paraventricular hypothalamus, and paraventricular thalamus, to those evoked by body pain. These results are consistent with recent preclinical findings of differential activation in the brainstem and subcortical limbic nuclei and associated cortices during cutaneous pain of the face when compared with the body. The findings suggest one potential mechanism by which facial pain could evoke a greater emotional impact than that evoked by body pain.
Collapse
Affiliation(s)
- Rebecca V Robertson
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, University of Sydney, 2006, Australia
| | - Noemi Meylakh
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, University of Sydney, 2006, Australia
| | - Lewis S Crawford
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, University of Sydney, 2006, Australia
| | - Fernando A Tinoco Mendoza
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, University of Sydney, 2006, Australia
| | - Paul M Macey
- UCLA School of Nursing and Brain Research Institute, University of California, Los Angeles, California, 90095, USA
| | | | - Kevin A Keay
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, University of Sydney, 2006, Australia
| | - Luke A Henderson
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, University of Sydney, 2006, Australia.
| |
Collapse
|
2
|
Jiao X, Hu Q, Tang Y, Zhang T, Zhang J, Wang X, Sun J, Wang J. Abnormal Global Cortical Responses in Drug-Naïve Patients With Schizophrenia Following Orbitofrontal Cortex Stimulation: A Concurrent Transcranial Magnetic Stimulation-Electroencephalography Study. Biol Psychiatry 2024; 96:342-351. [PMID: 38852897 DOI: 10.1016/j.biopsych.2024.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 05/16/2024] [Accepted: 05/31/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Abnormalities in cortical excitability and plasticity have been considered to underlie the pathophysiology of schizophrenia. Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) can provide a direct evaluation of cortical responses to TMS. Here, we employed TMS-EEG to investigate cortical responses to orbitofrontal cortex (OFC) stimulation in schizophrenia. METHODS In total, we recruited 92 drug-naïve patients with first-episode schizophrenia and 51 age- and sex-matched healthy individuals. For each participant, one session of 1-Hz repetitive TMS (rTMS) was delivered to the right OFC, and TMS-EEG data were obtained to explore the change in cortical-evoked activities before and immediately after rTMS during the eyes-closed state. The MATRICS Consensus Cognitive Battery was used to assess neurocognitive performance. RESULTS The cortical responses indexed by global mean field amplitudes (i.e., P30, N45, and P60) were larger in patients with schizophrenia than in healthy control participants at baseline. Furthermore, after one session of 1-Hz rTMS over the right OFC, the N100 amplitude was significantly reduced in the healthy control group but not in the schizophrenia group. In the healthy control participants, there was a significant correlation between modulation of P60 amplitude by rTMS and working memory; however, this correlation was absent in patients with schizophrenia. CONCLUSIONS Aberrant global cortical responses following right OFC stimulation were found in patients with drug-naïve first-episode schizophrenia, supporting its significance in the primary pathophysiology of schizophrenia.
Collapse
Affiliation(s)
- Xiong Jiao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Med.-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qiang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry, Zhenjiang Mental Health Center, Jiangsu, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Med.-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xijin Wang
- The First Psychiatric Hospital of Harbin, Harbin, Heilongjiang Province, China
| | - Junfeng Sun
- Shanghai Med.-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.
| |
Collapse
|
3
|
Allawala AB, Bijanki KR, Adkinson J, Oswalt D, Tsolaki E, Mathew S, Mathura RK, Bartoli E, Provenza N, Watrous AJ, Xiao J, Pirtle V, Mocchi MM, Rajesh S, Diab N, Cohn JF, Borton DA, Goodman WK, Pouratian N, Sheth SA. Stereo-Electroencephalography-Guided Network Neuromodulation for Psychiatric Disorders: The Neurophysiology Monitoring Unit. Oper Neurosurg (Hagerstown) 2024; 27:329-336. [PMID: 39145663 PMCID: PMC11315541 DOI: 10.1227/ons.0000000000001122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/19/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Recent advances in stereotactic and functional neurosurgery have brought forth the stereo-electroencephalography approach which allows deeper interrogation and characterization of the contributions of deep structures to neural and affective functioning. We argue that this approach can and should be brought to bear on the notoriously intractable issue of defining the pathophysiology of refractory psychiatric disorders and developing patient-specific optimized stimulation therapies. METHODS We have developed a suite of methods for maximally leveraging the stereo-electroencephalography approach for an innovative application to understand affective disorders, with high translatability across the broader range of refractory neuropsychiatric conditions. RESULTS This article provides a roadmap for determining desired electrode coverage, tracking high-resolution research recordings across a large number of electrodes, synchronizing intracranial signals with ongoing research tasks and other data streams, applying intracranial stimulation during recording, and design choices for patient comfort and safety. CONCLUSION These methods can be implemented across other neuropsychiatric conditions needing intensive electrophysiological characterization to define biomarkers and more effectively guide therapeutic decision-making in cases of severe and treatment-refractory disease.
Collapse
Affiliation(s)
- Anusha B. Allawala
- School of Engineering, Brown University, Providence, Rhode Island, USA
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
| | - Kelly R. Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Joshua Adkinson
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Denise Oswalt
- Department of Neurosurgery, University of Pennsylvania Philadelphia, Pennsylvania, USA
| | - Evangelia Tsolaki
- Department of Neurosurgery, University of California, Los Angeles, California, USA
| | - Sanjay Mathew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Raissa K. Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Eleonora Bartoli
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Nicole Provenza
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew J. Watrous
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Jiayang Xiao
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Victoria Pirtle
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Madaline M. Mocchi
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Sameer Rajesh
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Nabeel Diab
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Jeffrey F. Cohn
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - David A. Borton
- School of Engineering, Brown University, Providence, Rhode Island, USA
| | - Wayne K. Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Nader Pouratian
- Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, USA
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
4
|
Myers J, Xiao J, Mathura R, Shofty B, Pirtle V, Adkinson J, Allawala AB, Anand A, Gadot R, Najera R, Rey HG, Mathew SJ, Bijanki K, Banks G, Watrous A, Bartoli E, Heilbronner SR, Provenza N, Goodman WK, Pouratian N, Hayden BY, Sheth SA. Intracranial Directed Connectivity Links Subregions of the Prefrontal Cortex to Major Depression. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.07.24311546. [PMID: 39148826 PMCID: PMC11326344 DOI: 10.1101/2024.08.07.24311546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Understanding the neural basis of major depressive disorder (MDD) is vital to guiding neuromodulatory treatments. The available evidence supports the hypothesis that MDD is fundamentally a disease of cortical disinhibition, where breakdowns of inhibitory neural systems lead to diminished emotion regulation and intrusive ruminations. Recent research also points towards network changes in the brain, especially within the prefrontal cortex (PFC), as primary sources of MDD etiology. However, due to limitations in spatiotemporal resolution and clinical opportunities for intracranial recordings, this hypothesis has not been directly tested. We recorded intracranial EEG from the dorsolateral (dlPFC), orbitofrontal (OFC), and anterior cingulate cortices (ACC) in neurosurgical patients with MDD. We measured daily fluctuations in self-reported depression severity alongside directed connectivity between these PFC subregions. We focused primarily on delta oscillations (1-3 Hz), which have been linked to GABAergic inhibitory control and intracortical communication. Depression symptoms worsened when connectivity within the left vs. right PFC became imbalanced. In the left hemisphere, all directed connectivity towards the ACC, from the dlPFC and OFC, was positively correlated with depression severity. In the right hemisphere, directed connectivity between the OFC and dlPFC increased with depression severity as well. This is the first evidence that delta oscillations flowing between prefrontal subregions transiently increase intensity when people are experiencing more negative mood. These findings support the overarching hypothesis that MDD worsens with prefrontal disinhibition.
Collapse
Affiliation(s)
- John Myers
- Baylor College of Medicine, Department of Neurosurgery
| | - Jiayang Xiao
- Baylor College of Medicine, Department of Neurosurgery
| | | | - Ben Shofty
- Baylor College of Medicine, Department of Neurosurgery
| | | | | | | | - Adrish Anand
- Baylor College of Medicine, Department of Neurosurgery
| | - Ron Gadot
- Baylor College of Medicine, Department of Neurosurgery
| | | | - Hernan G. Rey
- Baylor College of Medicine, Department of Neurosurgery
| | - Sanjay J. Mathew
- Baylor College of Medicine, Department of Psychiatry and Behavioral Science
| | - Kelly Bijanki
- Baylor College of Medicine, Department of Neurosurgery
| | - Garrett Banks
- Baylor College of Medicine, Department of Neurosurgery
| | | | | | | | | | - Wayne K. Goodman
- University of Texas: Southwestern, Department of Neurological Surgery
| | - Nader Pouratian
- University of Texas: Southwestern, Department of Neurological Surgery
| | | | | |
Collapse
|
5
|
Simon J, Rich EL. Stimulating social interest: The translational value of basic investigations into frontal cortex function. Neuron 2024; 112:2461-2463. [PMID: 39116838 DOI: 10.1016/j.neuron.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 07/10/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024]
Abstract
Fan et al. use electrical stimulation during a novel social interaction paradigm to demonstrate a role for the orbitofrontal cortex in directing social attention. Their results shed new light on the basic functions of the orbitofrontal cortex and have translational value in understanding circuit modulation for psychiatric disorders.
Collapse
Affiliation(s)
- Joseph Simon
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Erin L Rich
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| |
Collapse
|
6
|
Hoy CW, de Hemptinne C, Wang SS, Harmer CJ, Apps MAJ, Husain M, Starr PA, Little S. Beta and theta oscillations track effort and previous reward in the human basal ganglia and prefrontal cortex during decision making. Proc Natl Acad Sci U S A 2024; 121:e2322869121. [PMID: 39047043 PMCID: PMC11295073 DOI: 10.1073/pnas.2322869121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
Choosing whether to exert effort to obtain rewards is fundamental to human motivated behavior. However, the neural dynamics underlying the evaluation of reward and effort in humans is poorly understood. Here, we report an exploratory investigation into this with chronic intracranial recordings from the prefrontal cortex (PFC) and basal ganglia (BG; subthalamic nuclei and globus pallidus) in people with Parkinson's disease performing a decision-making task with offers that varied in levels of reward and physical effort required. This revealed dissociable neural signatures of reward and effort, with BG beta (12 to 20 Hz) oscillations tracking effort on a single-trial basis and PFC theta (4 to 7 Hz) signaling previous trial reward, with no effects of net subjective value. Stimulation of PFC increased overall acceptance of offers and sensitivity to reward while decreasing the impact of effort on choices. This work uncovers oscillatory mechanisms that guide fundamental decisions to exert effort for reward across BG and PFC, supports a causal role of PFC for such choices, and seeds hypotheses for future studies.
Collapse
Affiliation(s)
- Colin W. Hoy
- Department of Neurology, University of California, San Francisco, CA94143
| | - Coralie de Hemptinne
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL32608
- Department of Neurology, University of Florida, Gainesville, FL32608
| | - Sarah S. Wang
- Department of Neurology, University of California, San Francisco, CA94143
| | - Catherine J. Harmer
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
| | - Matthew A. J. Apps
- Department of Experimental Psychology, University of Oxford, OxfordOX2 6GG, United Kingdom
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham UKB15 2TT, United Kingdom
- Centre for Human Brain Health, School of Psychology, University of Birmingham, BirminghamB15 2TT, United Kingdom
| | - Masud Husain
- Department of Experimental Psychology, University of Oxford, OxfordOX2 6GG, United Kingdom
- Nuffield Department of Clinical Neurosciences, University of Oxford, OxfordOX3 9DU, United Kingdom
| | - Philip A. Starr
- Department of Neurological Surgery, University of California, San Francisco, CA94143, United Kingdom
| | - Simon Little
- Department of Neurology, University of California, San Francisco, CA94143
| |
Collapse
|
7
|
Modak P, Fine J, Colon B, Need E, Cheng H, Hulvershorn L, Finn P, Brown JW. Temporal interference electrical neurostimulation at 20 Hz beat frequency leads to increased fMRI BOLD activation in orbitofrontal cortex in humans. Brain Stimul 2024; 17:867-875. [PMID: 39059712 DOI: 10.1016/j.brs.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 07/14/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024] Open
Abstract
Temporal interference electrical neurostimulation (TI) is a relatively new method of non-invasive neurostimulation that may be able to stimulate deep brain regions without stimulating the overlying superficial regions. Although some recent studies have demonstrated the success of TI in modulating task-induced BOLD activity in humans, there is limited information on intended and off-target effects of TI during resting-state. We simultaneously performed TI stimulation with the set-up optimized for maximum focality in the left caudate and collected resting-state fMRI data to investigate the effects of TI on human BOLD signals. We found increased BOLD activation in a part of the mid-orbitofrontal cortex (OFC) and parahippocampal gyrus. Results indicate that TI can induce increased BOLD activation in the region that receives the highest magnitude of TI amplitude modulation in humans, with good safety and tolerability profiles. We also show the limits of spatial precision and explore the nature and causes of additional off-target effects. TI may be a promising approach for addressing questions about the causal role of deep brain structures in human cognition and may also afford new clinical treatments.
Collapse
Affiliation(s)
- Priyamvada Modak
- Dept. of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Justin Fine
- Dept. of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Brayden Colon
- Dept. of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Ella Need
- The Family Institute, Northwestern University, Chicago, Illinois, IL, USA
| | - Hu Cheng
- Dept. of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Leslie Hulvershorn
- Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Peter Finn
- Dept. of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Joshua W Brown
- Dept. of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA.
| |
Collapse
|
8
|
Sadras N, Pesaran B, Shanechi MM. Event detection and classification from multimodal time series with application to neural data. J Neural Eng 2024; 21:026049. [PMID: 38513289 DOI: 10.1088/1741-2552/ad3678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/21/2024] [Indexed: 03/23/2024]
Abstract
The detection of events in time-series data is a common signal-processing problem. When the data can be modeled as a known template signal with an unknown delay in Gaussian noise, detection of the template signal can be done with a traditional matched filter. However, in many applications, the event of interest is represented in multimodal data consisting of both Gaussian and point-process time series. Neuroscience experiments, for example, can simultaneously record multimodal neural signals such as local field potentials (LFPs), which can be modeled as Gaussian, and neuronal spikes, which can be modeled as point processes. Currently, no method exists for event detection from such multimodal data, and as such our objective in this work is to develop a method to meet this need. Here we address this challenge by developing the multimodal event detector (MED) algorithm which simultaneously estimates event times and classes. To do this, we write a multimodal likelihood function for Gaussian and point-process observations and derive the associated maximum likelihood estimator of simultaneous event times and classes. We additionally introduce a cross-modal scaling parameter to account for model mismatch in real datasets. We validate this method in extensive simulations as well as in a neural spike-LFP dataset recorded during an eye-movement task, where the events of interest are eye movements with unknown times and directions. We show that the MED can successfully detect eye movement onset and classify eye movement direction. Further, the MED successfully combines information across data modalities, with multimodal performance exceeding unimodal performance. This method can facilitate applications such as the discovery of latent events in multimodal neural population activity and the development of brain-computer interfaces for naturalistic settings without constrained tasks or prior knowledge of event times.
Collapse
Affiliation(s)
- Nitin Sadras
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States of America
| | - Bijan Pesaran
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Maryam M Shanechi
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States of America
- Thomas Lord Department of Computer Science, Alfred E. Mann Department of Biomedical Engineering, and the Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, United States of America
| |
Collapse
|
9
|
Rajnicek AM, Casañ-Pastor N. Wireless control of nerve growth using bipolar electrodes: a new paradigm in electrostimulation. Biomater Sci 2024; 12:2180-2202. [PMID: 38358306 DOI: 10.1039/d3bm01946b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Electrical activity underpins all life, but is most familiar in the nervous system, where long range electrical signalling is essential for function. When this is lost (e.g., traumatic injury) or it becomes inefficient (e.g., demyelination), the use of external fields can compensate for at least some functional deficits. However, its potential to also promote biological repair at the cell level is underplayed despite abundant in vitro evidence for control of neuron growth. This perspective article considers specifically the emerging possibility of achieving cell growth through the interaction of external electric fields using conducting materials as unwired bipolar electrodes, and without intending stimulation of neuron electrical activity to be the primary consequence. The use of a wireless method to create electrical interactions represents a paradigm shift and may allow new applications in vivo where physical wiring is not possible. Within that scheme of thought an evaluation of specific materials and their dynamic responses as bipolar unwired electrodes is summarized and correlated with changes in dynamic nerve growth during stimulation, suggesting possible future schemes to achieve neural growth using bipolar unwired electrodes with specific characteristics. This strategy emphasizes how nerve growth can be encouraged at injury sites wirelessly to induce repair, as opposed to implanting devices that may substitute the neural signals.
Collapse
Affiliation(s)
- Ann M Rajnicek
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland, United KIngdom
| | - Nieves Casañ-Pastor
- Institut de Ciència de Materials de Barcelona, CSIC, Campus UAB, 08193 Bellaterra, Barcelona, Spain.
| |
Collapse
|
10
|
Zhang B, Rolls ET, Wang X, Xie C, Cheng W, Feng J. Roles of the medial and lateral orbitofrontal cortex in major depression and its treatment. Mol Psychiatry 2024; 29:914-928. [PMID: 38212376 DOI: 10.1038/s41380-023-02380-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024]
Abstract
We describe evidence for dissociable roles of the medial and lateral orbitofrontal cortex (OFC) in major depressive disorder (MDD) from structure, functional activation, functional connectivity, metabolism, and neurochemical systems. The reward-related medial orbitofrontal cortex has lower connectivity and less reward sensitivity in MDD associated with anhedonia symptoms; and the non-reward related lateral OFC has higher functional connectivity and more sensitivity to non-reward/aversive stimuli in MDD associated with negative bias symptoms. Importantly, we propose that conventional antidepressants act to normalize the hyperactive lateral (but not medial) OFC to reduce negative bias in MDD; while other treatments are needed to operate on the medial OFC to reduce anhedonia, with emerging evidence suggesting that ketamine may act in this way. The orbitofrontal cortex is the key cortical region in emotion and reward, and the current review presents much new evidence about the different ways that the medial and lateral OFC are involved in MDD.
Collapse
Affiliation(s)
- Bei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China
| | - Edmund T Rolls
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China.
- Oxford Centre for Computational Neuroscience, Oxford, UK.
- Department of Computer Science, University of Warwick, Coventry, UK.
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, PR China
- Medical Psychological Institute, Central South University, Changsha, PR China
- China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, PR China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, PR China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, PR China.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China.
- Department of Computer Science, University of Warwick, Coventry, UK.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, PR China.
- Zhangjiang Fudan International Innovation Center, Shanghai, PR China.
| |
Collapse
|
11
|
Toffanin T, Cattarinussi G, Ghiotto N, Lussignoli M, Pavan C, Pieri L, Schiff S, Finatti F, Romagnolo F, Folesani F, Nanni MG, Caruso R, Zerbinati L, Belvederi Murri M, Ferrara M, Pigato G, Grassi L, Sambataro F. Effects of electroconvulsive therapy on cortical thickness in depression: a systematic review. Acta Neuropsychiatr 2024:1-15. [PMID: 38343196 DOI: 10.1017/neu.2024.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Electroconvulsive therapy (ECT) is one of the most studied and validated available treatments for severe or treatment-resistant depression. However, little is known about the neural mechanisms underlying ECT. This systematic review aims to critically review all structural magnetic resonance imaging studies investigating longitudinal cortical thickness (CT) changes after ECT in patients with unipolar or bipolar depression. METHODS We performed a search on PubMed, Medline, and Embase to identify all available studies published before April 20, 2023. A total of 10 studies were included. RESULTS The investigations showed widespread increases in CT after ECT in depressed patients, involving mainly the temporal, insular, and frontal regions. In five studies, CT increases in a non-overlapping set of brain areas correlated with the clinical efficacy of ECT. The small sample size, heterogeneity in terms of populations, comorbidities, and ECT protocols, and the lack of a control group in some investigations limit the generalisability of the results. CONCLUSIONS Our findings support the idea that ECT can increase CT in patients with unipolar and bipolar depression. It remains unclear whether these changes are related to the clinical response. Future larger studies with longer follow-up are warranted to thoroughly address the potential role of CT as a biomarker of clinical response after ECT.
Collapse
Affiliation(s)
- Tommaso Toffanin
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Niccolò Ghiotto
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | | | - Chiara Pavan
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Luca Pieri
- Department of Medicine, University of Padova, Padua, Italy
| | - Sami Schiff
- Department of Medicine, University of Padova, Padua, Italy
| | - Francesco Finatti
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Francesca Romagnolo
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Federica Folesani
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Rosangela Caruso
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Maria Ferrara
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Giorgio Pigato
- Department of Psychiatry, Padova University Hospital, Padua, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
| |
Collapse
|
12
|
Allawala A, Bijanki KR, Oswalt D, Mathura RK, Adkinson J, Pirtle V, Shofty B, Robinson M, Harrison MT, Mathew SJ, Goodman WK, Pouratian N, Sheth SA, Borton DA. Prefrontal network engagement by deep brain stimulation in limbic hubs. Front Hum Neurosci 2024; 17:1291315. [PMID: 38283094 PMCID: PMC10813208 DOI: 10.3389/fnhum.2023.1291315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Prefrontal circuits in the human brain play an important role in cognitive and affective processing. Neuromodulation therapies delivered to certain key hubs within these circuits are being used with increasing frequency to treat a host of neuropsychiatric disorders. However, the detailed neurophysiological effects of stimulation to these hubs are largely unknown. Here, we performed intracranial recordings across prefrontal networks while delivering electrical stimulation to two well-established white matter hubs involved in cognitive regulation and depression: the subcallosal cingulate (SCC) and ventral capsule/ventral striatum (VC/VS). We demonstrate a shared frontotemporal circuit consisting of the ventromedial prefrontal cortex, amygdala, and lateral orbitofrontal cortex where gamma oscillations are differentially modulated by stimulation target. Additionally, we found participant-specific responses to stimulation in the dorsal anterior cingulate cortex and demonstrate the capacity for further tuning of neural activity using current-steered stimulation. Our findings indicate a potential neurophysiological mechanism for the dissociable therapeutic effects seen across the SCC and VC/VS targets for psychiatric neuromodulation and our results lay the groundwork for personalized, network-guided neurostimulation therapy.
Collapse
Affiliation(s)
- Anusha Allawala
- School of Engineering, Brown University, Providence, RI, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Kelly R. Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Denise Oswalt
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Raissa K. Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Joshua Adkinson
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Victoria Pirtle
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Ben Shofty
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, United States
| | - Meghan Robinson
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Matthew T. Harrison
- Division of Applied Mathematics, Brown University, Providence, RI, United States
| | - Sanjay J. Mathew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Wayne K. Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Nader Pouratian
- Department of Neurological Surgery, UT Southwestern Medical Center, Dallas, TX, United States
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - David A. Borton
- School of Engineering, Brown University, Providence, RI, United States
- Department of Veterans Affairs, Center for Neurorestoration and Neurotechnology, Providence, RI, United States
| |
Collapse
|
13
|
Sellers KK, Cohen JL, Khambhati AN, Fan JM, Lee AM, Chang EF, Krystal AD. Closed-loop neurostimulation for the treatment of psychiatric disorders. Neuropsychopharmacology 2024; 49:163-178. [PMID: 37369777 PMCID: PMC10700557 DOI: 10.1038/s41386-023-01631-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Despite increasing prevalence and huge personal and societal burden, psychiatric diseases still lack treatments which can control symptoms for a large fraction of patients. Increasing insight into the neurobiology underlying these diseases has demonstrated wide-ranging aberrant activity and functioning in multiple brain circuits and networks. Together with varied presentation and symptoms, this makes one-size-fits-all treatment a challenge. There has been a resurgence of interest in the use of neurostimulation as a treatment for psychiatric diseases. Initial studies using continuous open-loop stimulation, in which clinicians adjusted stimulation parameters during patient visits, showed promise but also mixed results. Given the periodic nature and fluctuations of symptoms often observed in psychiatric illnesses, the use of device-driven closed-loop stimulation may provide more effective therapy. The use of a biomarker, which is correlated with specific symptoms, to deliver stimulation only during symptomatic periods allows for the personalized therapy needed for such heterogeneous disorders. Here, we provide the reader with background motivating the use of closed-loop neurostimulation for the treatment of psychiatric disorders. We review foundational studies of open- and closed-loop neurostimulation for neuropsychiatric indications, focusing on deep brain stimulation, and discuss key considerations when designing and implementing closed-loop neurostimulation.
Collapse
Affiliation(s)
- Kristin K Sellers
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Joshua L Cohen
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Ankit N Khambhati
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Joline M Fan
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, CA, USA
| | - A Moses Lee
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Andrew D Krystal
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
| |
Collapse
|
14
|
Downar J, Siddiqi SH, Mitra A, Williams N, Liston C. Mechanisms of Action of TMS in the Treatment of Depression. Curr Top Behav Neurosci 2024; 66:233-277. [PMID: 38844713 DOI: 10.1007/7854_2024_483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Transcranial magnetic stimulation (TMS) is entering increasingly widespread use in treating depression. The most common stimulation target, in the dorsolateral prefrontal cortex (DLPFC), emerged from early neuroimaging studies in depression. Recently, more rigorous casual methods have revealed whole-brain target networks and anti-networks based on the effects of focal brain lesions and focal brain stimulation on depression symptoms. Symptom improvement during therapeutic DLPFC-TMS appears to involve directional changes in signaling between the DLPFC, subgenual and dorsal anterior cingulate cortex, and salience-network regions. However, different networks may be involved in the therapeutic mechanisms for other TMS targets in depression, such as dorsomedial prefrontal cortex or orbitofrontal cortex. The durability of therapeutic effects for TMS involves synaptic neuroplasticity, and specifically may depend upon dopamine acting at the D1 receptor family, as well as NMDA-receptor-dependent synaptic plasticity mechanisms. Although TMS protocols are classically considered 'excitatory' or 'inhibitory', the actual effects in individuals appear quite variable, and might be better understood at the level of populations of synapses rather than individual synapses. Synaptic meta-plasticity may provide a built-in protective mechanism to avoid runaway facilitation or inhibition during treatment, and may account for the relatively small number of patients who worsen rather than improve with TMS. From an ethological perspective, the antidepressant effects of TMS may involve promoting a whole-brain attractor state associated with foraging/hunting behaviors, centered on the rostrolateral periaqueductal gray and salience network, and suppressing an attractor state associated with passive threat defense, centered on the ventrolateral periaqueductal gray and default-mode network.
Collapse
Affiliation(s)
- Jonathan Downar
- Department of Psychiatry, Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Shan H Siddiqi
- Center for Brain Circuit Therapeutics, Brigham & Women's Hospital, Boston, MA, USA
- Department of Psychiatry, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anish Mitra
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Nolan Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Conor Liston
- Department of Psychiatry, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
15
|
Hoy CW, de Hemptinne C, Wang SS, Harmer CJ, Apps MAJ, Husain M, Starr PA, Little S. Beta and theta oscillations track effort and previous reward in human basal ganglia and prefrontal cortex during decision making. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.05.570285. [PMID: 38106063 PMCID: PMC10723308 DOI: 10.1101/2023.12.05.570285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Choosing whether to exert effort to obtain rewards is fundamental to human motivated behavior. However, the neural dynamics underlying the evaluation of reward and effort in humans is poorly understood. Here, we investigate this with chronic intracranial recordings from prefrontal cortex (PFC) and basal ganglia (BG; subthalamic nuclei and globus pallidus) in people with Parkinson's disease performing a decision-making task with offers that varied in levels of reward and physical effort required. This revealed dissociable neural signatures of reward and effort, with BG beta (12-20 Hz) oscillations tracking subjective effort on a single trial basis and PFC theta (4-7 Hz) signaling previous trial reward. Stimulation of PFC increased overall acceptance of offers in addition to increasing the impact of reward on choices. This work uncovers oscillatory mechanisms that guide fundamental decisions to exert effort for reward across BG and PFC, as well as supporting a causal role of PFC for such choices.
Collapse
Affiliation(s)
- Colin W. Hoy
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Coralie de Hemptinne
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Sarah S. Wang
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | | | - Mathew A. J. Apps
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Masud Husain
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Philip A. Starr
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Simon Little
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
16
|
Munot S, Kim N, Huang Y, Keller CJ. Direct cortical stimulation induces short-term plasticity of neural oscillations in humans. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.15.567302. [PMID: 38014071 PMCID: PMC10680685 DOI: 10.1101/2023.11.15.567302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Patterned brain stimulation is commonly employed as a tool for eliciting plasticity in brain circuits and treating neuropsychiatric disorders. Although widely used in clinical settings, there remains a limited understanding of how stimulation-induced plasticity influences neural oscillations and their interplay with the underlying baseline functional architecture. To address this question, we applied 15 minutes of 10Hz focal electrical simulation, a pattern identical to 'excitatory' repetitive transcranial magnetic stimulation (rTMS), to 14 medically-intractable epilepsy patients undergoing intracranial electroencephalographic (iEEG). We quantified the spectral features of the cortico-cortical evoked potential (CCEPs) in these patients before and after stimulation. We hypothesized that for a given region the temporal and spectral components of the CCEP predicted the location and degree of stimulation-induced plasticity. Across patients, low frequency power (alpha and beta) showed the broadest change, while the magnitude of change was stronger in high frequencies (beta and gamma). Next we demonstrated that regions with stronger baseline evoked spectral responses were more likely to undergo plasticity after stimulation. These findings were specific to a given frequency in a specific temporal window. Post-stimulation power changes were driven by the interaction between direction of change in baseline power and temporal window of change. Finally, regions exhibiting early increases and late decreases in evoked baseline power exhibited power changes after stimulation and were independent of stimulation location. Together, these findings that time-frequency baseline features predict post-stimulation plasticity effects demonstrate properties akin to Hebbian learning in humans and extend this theory to the temporal and spectral window of interest. These findings can help improve our understanding of human brain plasticity and lead to more effective brain stimulation techniques. Significance Statement Brain stimulation is increasingly used to treat neuropsychiatric disorders by inducing changes in neural activity at specific brain regions. Despite their effectiveness, how these changes occur, specifically in the spectral domain, is unknown. To better understand how brain oscillations change after patterned stimulation, we performed focused stimulation in epilepsy patients and measured intracranial brain recordings. We found strong and predictable changes in brain oscillations (plasticity) after patterned stimulation. Specifically, low frequencies showing widespread effects and high frequencies exhibiting a greater magnitude of change. These changes were directly related to the temporal and spectral structure of brain responses prior to stimulation. Our study reveals that baseline brain activity patterns can predict how stimulation will induce plasticity in the spectral domain. These findings can help improve our understanding of human brain plasticity and lead to more effective brain stimulation techniques. Highlights We applied 15 minutes of repetitive 10Hz focal electrical stimulation and assessed the evoked brain-wide spectral changes with intracranial EEG.10Hz stimulation induced short-term plasticity in low frequency alpha evoked power broadly across regions and time windows and high frequency (beta, gamma) power specifically in early evoked time windows (10-50ms).Across patients, frequency bands, and time windows, brain regions with stronger baseline evoked power were more likely to undergo greater spectral changes after 10Hz stimulation.Post-stimulation spectral changes were specific; that is, for a given frequency band in a specific time window, baseline evoked power predicted post-stimulation change in the same frequency band and time window.Post-stimulation spectral change was driven by an interaction between direction of change and temporal window of baseline power; that is, regions exhibiting baseline evoked early (10-100ms) increases and late (100-200ms) decreases in power correlated with observed post-stimulation spectral changes.These results were independent of stimulation location.
Collapse
|
17
|
Prentice A, Kolken Y, Tuttle C, van Neijenhof J, Pitch R, van Oostrom I, Kruiver V, Downar J, Sack AT, Arns M, van der Vinne N. 1Hz right orbitofrontal TMS benefits depressed patients unresponsive to dorsolateral prefrontal cortex TMS. Brain Stimul 2023; 16:1572-1575. [PMID: 37839775 DOI: 10.1016/j.brs.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023] Open
Affiliation(s)
- Amourie Prentice
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Synaeda Research, Synaeda Psycho Medisch Centrum, De Opgang 2-1, 9203 GD, Drachten, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Ylka Kolken
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Christina Tuttle
- Long Island Neurocare Therapy, 1739 N. Ocean Ave. Suite A, Medford, NY, 11763, Long Island, USA
| | | | - Richard Pitch
- Long Island Neurocare Therapy, 1739 N. Ocean Ave. Suite A, Medford, NY, 11763, Long Island, USA
| | - Iris van Oostrom
- Neurocare Clinics, Bijleveldsingel 34, 6524 AD, Nijmegen, Netherlands
| | - Vera Kruiver
- Neurocare Clinics, Bijleveldsingel 34, 6524 AD, Nijmegen, Netherlands
| | - Jonathan Downar
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street 8th Floor. Toronto, Ontario, M5T 1R8, Canada
| | - Alexander T Sack
- Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Martijn Arns
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Synaeda Research, Synaeda Psycho Medisch Centrum, De Opgang 2-1, 9203 GD, Drachten, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Nikita van der Vinne
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Synaeda Research, Synaeda Psycho Medisch Centrum, De Opgang 2-1, 9203 GD, Drachten, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands.
| |
Collapse
|
18
|
Cao D, Liu Q, Zhang J, Li J, Jiang T. State-specific modulation of mood using intracranial electrical stimulation of the orbitofrontal cortex. Brain Stimul 2023; 16:1112-1122. [PMID: 37467951 DOI: 10.1016/j.brs.2023.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Orbitofrontal cortex (OFC) is a promising target for intracranial electrical stimulation (iES) aimed at improving mood states. However, knowledge gaps remain regarding the underlying neural mechanisms of iES effects, such as the effect of the OFC target in comparison with other emotional network targets, the impact of brain state at the time of stimulation, and the neural response induced by iES at both local and network scales. OBJECTIVE Our study aims to address the neural mechanisms underlying the effects of iES in improving mood states. METHODS We conducted a study in 24 epilepsy patients who received iES through implanted electrodes in the emotional network and compared the effects of iES on multiple targets in the emotional network. RESULTS We found that only iES applied to the orbitofrontal cortex (OFC) led to mood improvement and changes in neural activity. We also observed that iES to the OFC suppressed the delta-theta power when the brain was in a low mood state. Moreover, the iES to the OFC decreased delta-theta power and increased gamma power at local regions within the emotional network, and enhanced the information flow through the frequency domain among regions within the emotional network. CONCLUSIONS These findings provide insight into the neural correlates of iES-induced mood improvement and support the potential of iES as a therapeutic intervention for mood disorders.
Collapse
Affiliation(s)
- Dan Cao
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Qihong Liu
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiaqi Zhang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jin Li
- School of Psychology, Capital Normal University, Beijing, 100048, China.
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China; Research Center for Augmented Intelligence, Zhejiang Lab, 311100, Hangzhou, China.
| |
Collapse
|
19
|
Fan JM, Lee AM, Sellers KK, Woodworth K, Makhoul GS, Liu TX, Henderson C, Astudillo Maya DA, Martinez R, Zamanian H, Speidel BA, Khambhati AN, Rao VR, Sugrue LP, Scangos KW, Chang EF, Krystal AD. Intracranial electrical stimulation of corticolimbic sites modulates arousal in humans. Brain Stimul 2023; 16:1072-1082. [PMID: 37385540 PMCID: PMC10634663 DOI: 10.1016/j.brs.2023.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Humans routinely shift their sleepiness and wakefulness levels in response to emotional factors. The diversity of emotional factors that modulates sleep-wake levels suggests that the ascending arousal network may be intimately linked with networks that mediate mood. Indeed, while animal studies have identified select limbic structures that play a role in sleep-wake regulation, the breadth of corticolimbic structures that directly modulates arousal in humans remains unknown. OBJECTIVE We investigated whether select regional activation of the corticolimbic network through direct electrical stimulation can modulate sleep-wake levels in humans, as measured by subjective experience and behavior. METHODS We performed intensive inpatient stimulation mapping in two human participants with treatment resistant depression, who underwent intracranial implantation with multi-site, bilateral depth electrodes. Stimulation responses of sleep-wake levels were measured by subjective surveys (i.e. Stanford Sleepiness Scale and visual-analog scale of energy) and a behavioral arousal score. Biomarker analyses of sleep-wake levels were performed by assessing spectral power features of resting-state electrophysiology. RESULTS Our findings demonstrated three regions whereby direct stimulation modulated arousal, including the orbitofrontal cortex (OFC), subgenual cingulate (SGC), and, most robustly, ventral capsule (VC). Modulation of sleep-wake levels was frequency-specific: 100Hz OFC, SGC, and VC stimulation promoted wakefulness, whereas 1Hz OFC stimulation increased sleepiness. Sleep-wake levels were correlated with gamma activity across broad brain regions. CONCLUSIONS Our findings provide evidence for the overlapping circuitry between arousal and mood regulation in humans. Furthermore, our findings open the door to new treatment targets and the consideration of therapeutic neurostimulation for sleep-wake disorders.
Collapse
Affiliation(s)
- Joline M Fan
- Department of Neurology, University of California, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
| | - A Moses Lee
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Kristin K Sellers
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Neurosurgery, University of California, San Francisco, CA, USA
| | - Kai Woodworth
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Ghassan S Makhoul
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Tony X Liu
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Catherine Henderson
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Daniela A Astudillo Maya
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Rebecca Martinez
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Hashem Zamanian
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Benjamin A Speidel
- Department of Neurology, University of California, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Ankit N Khambhati
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Neurosurgery, University of California, San Francisco, CA, USA
| | - Vikram R Rao
- Department of Neurology, University of California, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Leo P Sugrue
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA
| | - Katherine W Scangos
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Edward F Chang
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Neurosurgery, University of California, San Francisco, CA, USA
| | - Andrew D Krystal
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| |
Collapse
|
20
|
Wang Y, Cao Q, Wei C, Xu F, Zhang P, Zeng H, Shao Y, Weng X, Meng R. The Effect of Transcranial Electrical Stimulation on the Recovery of Sleep Quality after Sleep Deprivation Based on an EEG Analysis. Brain Sci 2023; 13:933. [PMID: 37371411 DOI: 10.3390/brainsci13060933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Acute sleep deprivation can reduce the cognitive ability and change the emotional state in humans. However, little is known about how brain EEGs and facial expressions change during acute sleep deprivation (SD). Herein, we employed 34 healthy adult male subjects to undergo acute SD for 36 h, during which, their emotional states and brain EEG power were measured. The subjects were divided randomly into electronic stimulation and control groups. We performed TDCS on the left dorsolateral prefrontal cortex for 2 mA and 30 min in the TDCS group. These results indicated that the proportion of disgusted expressions in the electrical stimulation group was significantly less than the controls after 36 h post-acute SD, while the proportion of neutral expressions was increased post-restorative sleep. Furthermore, the electrical stimulation group presented a more significant impact on slow wave power (theta and delta) than the controls. These findings indicated that emotional changes occurred in the subjects after 36 h post-acute SD, while electrical stimulation could effectively regulate the cortical excitability and excitation inhibition balance after acute SD.
Collapse
Affiliation(s)
- Yuhan Wang
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Qiongfang Cao
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Changyou Wei
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Fan Xu
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Peng Zhang
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Hanrui Zeng
- Department of Clinic Medicine, Chengdu Medical College, Chengdu 610500, China
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Xiechuan Weng
- Department of Neuroscience, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Rong Meng
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| |
Collapse
|
21
|
Shirvalkar P, Prosky J, Chin G, Ahmadipour P, Sani OG, Desai M, Schmitgen A, Dawes H, Shanechi MM, Starr PA, Chang EF. First-in-human prediction of chronic pain state using intracranial neural biomarkers. Nat Neurosci 2023; 26:1090-1099. [PMID: 37217725 PMCID: PMC10330878 DOI: 10.1038/s41593-023-01338-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/18/2023] [Indexed: 05/24/2023]
Abstract
Chronic pain syndromes are often refractory to treatment and cause substantial suffering and disability. Pain severity is often measured through subjective report, while objective biomarkers that may guide diagnosis and treatment are lacking. Also, which brain activity underlies chronic pain on clinically relevant timescales, or how this relates to acute pain, remains unclear. Here four individuals with refractory neuropathic pain were implanted with chronic intracranial electrodes in the anterior cingulate cortex and orbitofrontal cortex (OFC). Participants reported pain metrics coincident with ambulatory, direct neural recordings obtained multiple times daily over months. We successfully predicted intraindividual chronic pain severity scores from neural activity with high sensitivity using machine learning methods. Chronic pain decoding relied on sustained power changes from the OFC, which tended to differ from transient patterns of activity associated with acute, evoked pain states during a task. Thus, intracranial OFC signals can be used to predict spontaneous, chronic pain state in patients.
Collapse
Affiliation(s)
- Prasad Shirvalkar
- UCSF Department of Anesthesiology and Perioperative Care, Division of Pain Medicine, University of California San Francisco, San Francisco, CA, USA.
- UCSF Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
| | - Jordan Prosky
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Gregory Chin
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Parima Ahmadipour
- Departments of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Omid G Sani
- Departments of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Maansi Desai
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Ashlyn Schmitgen
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Heather Dawes
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Maryam M Shanechi
- Departments of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Philip A Starr
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- UCSF Department of Physiology, University of California San Francisco, San Francisco, CA, USA
| | - Edward F Chang
- UCSF Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- UCSF Department of Physiology, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
22
|
Fulton SL, Bendl J, Gameiro-Ros I, Fullard JF, Al-Kachak A, Lepack AE, Stewart AF, Singh S, Poller WC, Bastle RM, Hauberg ME, Fakira AK, Chen M, Cuttoli RDD, Cathomas F, Ramakrishnan A, Gleason K, Shen L, Tamminga CA, Milosevic A, Russo SJ, Swirski F, Blitzer RD, Slesinger PA, Roussos P, Maze I. ZBTB7A regulates MDD-specific chromatin signatures and astrocyte-mediated stress vulnerability in orbitofrontal cortex. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.04.539425. [PMID: 37205394 PMCID: PMC10187272 DOI: 10.1101/2023.05.04.539425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Hyperexcitability in the orbitofrontal cortex (OFC) is a key clinical feature of anhedonic domains of Major Depressive Disorder (MDD). However, the cellular and molecular substrates underlying this dysfunction remain unknown. Here, cell-population-specific chromatin accessibility profiling in human OFC unexpectedly mapped genetic risk for MDD exclusively to non-neuronal cells, and transcriptomic analyses revealed significant glial dysregulation in this region. Characterization of MDD-specific cis-regulatory elements identified ZBTB7A - a transcriptional regulator of astrocyte reactivity - as an important mediator of MDD-specific chromatin accessibility and gene expression. Genetic manipulations in mouse OFC demonstrated that astrocytic Zbtb7a is both necessary and sufficient to promote behavioral deficits, cell-type-specific transcriptional and chromatin profiles, and OFC neuronal hyperexcitability induced by chronic stress - a major risk factor for MDD. These data thus highlight a critical role for OFC astrocytes in stress vulnerability and pinpoint ZBTB7A as a key dysregulated factor in MDD that mediates maladaptive astrocytic functions driving OFC hyperexcitability.
Collapse
Affiliation(s)
- Sasha L. Fulton
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jaroslav Bendl
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Isabel Gameiro-Ros
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John F. Fullard
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Amni Al-Kachak
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashley E. Lepack
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew F. Stewart
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sumnima Singh
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- The Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Wolfram C. Poller
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- The Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Ryan M. Bastle
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mads E. Hauberg
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Amanda K. Fakira
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Min Chen
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Romain Durand-de Cuttoli
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Flurin Cathomas
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aarthi Ramakrishnan
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kelly Gleason
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Li Shen
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carol A. Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ana Milosevic
- Laboratory of Molecular and Cellular Neuroscience, Rockefeller University, New York, New York, USA
| | - Scott J. Russo
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Filip Swirski
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- The Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Robert D. Blitzer
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Paul A. Slesinger
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Panos Roussos
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Center for Dementia Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
- Mental Illness Research Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, New York, USA
| | - Ian Maze
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Howard Hughes Medical Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
23
|
Wang Z, Nan T, Goerlich KS, Li Y, Aleman A, Luo Y, Xu P. Neurocomputational mechanisms underlying fear-biased adaptation learning in changing environments. PLoS Biol 2023; 21:e3001724. [PMID: 37126501 PMCID: PMC10174591 DOI: 10.1371/journal.pbio.3001724] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 05/11/2023] [Accepted: 03/31/2023] [Indexed: 05/02/2023] Open
Abstract
Humans are able to adapt to the fast-changing world by estimating statistical regularities of the environment. Although fear can profoundly impact adaptive behaviors, the computational and neural mechanisms underlying this phenomenon remain elusive. Here, we conducted a behavioral experiment (n = 21) and a functional magnetic resonance imaging experiment (n = 37) with a novel cue-biased adaptation learning task, during which we simultaneously manipulated emotional valence (fearful/neutral expressions of the cue) and environmental volatility (frequent/infrequent reversals of reward probabilities). Across 2 experiments, computational modeling consistently revealed a higher learning rate for the environment with frequent versus infrequent reversals following neutral cues. In contrast, this flexible adjustment was absent in the environment with fearful cues, suggesting a suppressive role of fear in adaptation to environmental volatility. This suppressive effect was underpinned by activity of the ventral striatum, hippocampus, and dorsal anterior cingulate cortex (dACC) as well as increased functional connectivity between the dACC and temporal-parietal junction (TPJ) for fear with environmental volatility. Dynamic causal modeling identified that the driving effect was located in the TPJ and was associated with dACC activation, suggesting that the suppression of fear on adaptive behaviors occurs at the early stage of bottom-up processing. These findings provide a neuro-computational account of how fear interferes with adaptation to volatility during dynamic environments.
Collapse
Affiliation(s)
- Zhihao Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China
- CNRS-Centre d'Economie de la Sorbonne, Panthéon-Sorbonne University, France
| | - Tian Nan
- School of Psychology, Sichuan Center of Applied Psychology, Chengdu Medical College, Chengdu, China
| | - Katharina S Goerlich
- University of Groningen, Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, Groningen, the Netherlands
| | - Yiman Li
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Magnetic Resonance Imaging, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
| | - André Aleman
- University of Groningen, Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, Groningen, the Netherlands
| | - Yuejia Luo
- School of Psychology, Sichuan Center of Applied Psychology, Chengdu Medical College, Chengdu, China
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Magnetic Resonance Imaging, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- The State Key Lab of Cognitive and Learning, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Pengfei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
| |
Collapse
|
24
|
McLaughlin NCR, Magnotti JF, Banks GP, Nanda P, Hoexter MQ, Lopes AC, Batistuzzo MC, Asaad WF, Stewart C, Paulo D, Noren G, Greenberg BD, Malloy P, Salloway S, Correia S, Pathak Y, Sheehan J, Marsland R, Gorgulho A, De Salles A, Miguel EC, Rasmussen SA, Sheth SA. Gamma knife capsulotomy for intractable OCD: Neuroimage analysis of lesion size, location, and clinical response. Transl Psychiatry 2023; 13:134. [PMID: 37185805 PMCID: PMC10130137 DOI: 10.1038/s41398-023-02425-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 02/27/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) affects 2-3% of the population. One-third of patients are poorly responsive to conventional therapies, and for a subgroup, gamma knife capsulotomy (GKC) is an option. We examined lesion characteristics in patients previously treated with GKC through well-established programs in Providence, RI (Butler Hospital/Rhode Island Hospital/Alpert Medical School of Brown University) and São Paulo, Brazil (University of São Paolo). Lesions were traced on T1 images from 26 patients who had received GKC targeting the ventral half of the anterior limb of the internal capsule (ALIC), and the masks were transformed into MNI space. Voxel-wise lesion-symptom mapping was performed to assess the influence of lesion location on Y-BOCS ratings. General linear models were built to compare the relationship between lesion size/location along different axes of the ALIC and above or below-average change in Y-BOCS ratings. Sixty-nine percent of this sample were full responders (≥35% improvement in OCD). Lesion occurrence anywhere within the targeted region was associated with clinical improvement, but modeling results demonstrated that lesions occurring posteriorly (closer to the anterior commissure) and dorsally (closer to the mid-ALIC) were associated with the greatest Y-BOCS reduction. No association was found between Y-BOCS reduction and overall lesion volume. GKC remains an effective treatment for refractory OCD. Our data suggest that continuing to target the bottom half of the ALIC in the coronal plane is likely to provide the dorsal-ventral height required to achieve optimal outcomes, as it will cover the white matter pathways relevant to change. Further analysis of individual variability will be essential for improving targeting and clinical outcomes, and potentially further reducing the lesion size necessary for beneficial outcomes.
Collapse
Affiliation(s)
- N C R McLaughlin
- Butler Hospital, Providence, RI, USA.
- Alpert Medical School of Brown University, Providence, RI, USA.
| | - J F Magnotti
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - G P Banks
- Columbia University Medical Center, New York, NY, USA
| | - P Nanda
- Columbia University Medical Center, New York, NY, USA
| | - M Q Hoexter
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - A C Lopes
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - M C Batistuzzo
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil
| | - W F Asaad
- Alpert Medical School of Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
| | - C Stewart
- Boston University School of Public Health, Boston, MA, USA
| | - D Paulo
- Columbia University Medical Center, New York, NY, USA
| | - G Noren
- Alpert Medical School of Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
| | - B D Greenberg
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
- Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - P Malloy
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - S Salloway
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - S Correia
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Y Pathak
- Columbia University Medical Center, New York, NY, USA
| | - J Sheehan
- University of Virginia, Charlottesville, VA, USA
| | | | - A Gorgulho
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - A De Salles
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - E C Miguel
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - S A Rasmussen
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
| | - S A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
25
|
Fattahi M, Eskandari K, Riahi E, Khosrowabadi R, Haghparast A. Distinct suppressing effects of deep brain stimulation in the orbitofrontal cortex on the development, extinction, and reinstatement of methamphetamine-seeking behaviors. Life Sci 2023; 322:121613. [PMID: 36948388 DOI: 10.1016/j.lfs.2023.121613] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/10/2023] [Accepted: 03/18/2023] [Indexed: 03/24/2023]
Abstract
AIMS The orbitofrontal cortex (OFC) is implicated in compulsive drug-seeking and relapse, the characteristics that result in addiction treatment failure. Structural and functional impairments within the OFC have been detected in many substance use disorders (SUDs). Deep brain stimulation (DBS) is proposed as a promising therapeutic option in treating SUDs. Therefore, the present study aimed to investigate the potential efficacy of DBS application on the various stages of the methamphetamine-conditioned place preference (CPP) paradigm in rats. MAIN METHODS Electrodes were implanted unilaterally in the rat's right OFC. DBS in the form of high- or low-frequency stimulation (HFS: 130 Hz, LFS: 13 Hz) was applied during the 5-day conditioning phase (a daily 30-min session) or extinction period (30-min session, daily, ten days) of methamphetamine-induced CPP in two separate sets of experiments. Following extinction, place preference was reinstated by injecting a priming dose of methamphetamine (0.25 mg/kg). KEY FINDINGS The HFS and LFS significantly decreased the methamphetamine place preference when applied over the conditioning period. In the extinction experiment, only HFS could remarkably accelerate the extinction of reward-context associations and even reduce the methamphetamine-induced reinstatement of seeking behaviors. SIGNIFICANCE Conclusively, DBS administration in the OFC demonstrated some positive results, including suppressing effects on the development, maintenance, and relapse of methamphetamine-seeking behavior. These findings encourage conducting more preclinical studies to strongly suggest a wide range of DBS applications in cortical areas such as OFC as an efficient treatment modality for psychostimulant use disorder.
Collapse
Affiliation(s)
- Mojdeh Fattahi
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kiarash Eskandari
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esmail Riahi
- Department of Physiology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Abbas Haghparast
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences, Tehran, Iran; Department of Basic Sciences, Iranian Academy of Medical Sciences, Tehran, Iran.
| |
Collapse
|
26
|
Elliott MV, Esmail SAS, Weiner KS, Johnson SL. Neuroanatomical Correlates of Emotion-Related Impulsivity. Biol Psychiatry 2023; 93:566-574. [PMID: 36244800 PMCID: PMC9898470 DOI: 10.1016/j.biopsych.2022.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Emotion-related impulsivity (ERI) refers to chronically poor self-control during periods of strong emotion. ERI robustly predicts psychiatric disorders and related problems, yet its neuroanatomical correlates are largely unknown. We tested whether local brain morphometry in targeted brain regions that integrate emotion and control could explain ERI severity. METHODS One hundred twenty-two adults (ages 18-55 years) with internalizing or externalizing psychopathology completed a structural magnetic resonance imaging (MRI) scan, the Three-Factor Impulsivity Index, and the Structured Clinical Interview for DSM-5. The Three-Factor Impulsivity Index measures two types of ERI and a third type of impulsivity not linked to emotion. Cortical reconstruction yielded cortical thickness and local gyrification measurements. We evaluated whether morphometry in the orbitofrontal cortex (OFC), insula, amygdala, and nucleus accumbens was associated with ERI severity. Hypotheses and analyses were preregistered. RESULTS Lower cortical gyrification in the right lateral OFC was associated with high ERI severity in a full, preregistered model. Separate examinations of local gyrification and cortical thickness also showed a positive association between gyrification in the left lateral OFC and ERI. An integrated measure of hemispheric imbalance in lateral OFC gyrification (right < left) correlated with ERI severity. These findings were specific to ERI and did not appear with non-emotion-related impulsivity. CONCLUSIONS Local gyrification in the lateral OFC is associated with ERI severity. The current findings fit with existing theories of OFC function, strengthen the connections between the transdiagnostic literature in psychiatry and neuroscience, and may guide future treatment development.
Collapse
Affiliation(s)
- Matthew V Elliott
- Department of Psychology, University of California at Berkeley, Berkeley, California.
| | - Serajh A S Esmail
- Department of Psychology, University of California at Berkeley, Berkeley, California
| | - Kevin S Weiner
- Department of Psychology, University of California at Berkeley, Berkeley, California; Helen Wills Neuroscience Institute, University of California at Berkeley, Berkeley, California
| | - Sheri L Johnson
- Department of Psychology, University of California at Berkeley, Berkeley, California
| |
Collapse
|
27
|
Scangos KW, State MW, Miller AH, Baker JT, Williams LM. New and emerging approaches to treat psychiatric disorders. Nat Med 2023; 29:317-333. [PMID: 36797480 PMCID: PMC11219030 DOI: 10.1038/s41591-022-02197-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/21/2022] [Indexed: 02/18/2023]
Abstract
Psychiatric disorders are highly prevalent, often devastating diseases that negatively impact the lives of millions of people worldwide. Although their etiological and diagnostic heterogeneity has long challenged drug discovery, an emerging circuit-based understanding of psychiatric illness is offering an important alternative to the current reliance on trial and error, both in the development and in the clinical application of treatments. Here we review new and emerging treatment approaches, with a particular emphasis on the revolutionary potential of brain-circuit-based interventions for precision psychiatry. Limitations of circuit models, challenges of bringing precision therapeutics to market and the crucial advances needed to overcome these obstacles are presented.
Collapse
Affiliation(s)
- Katherine W Scangos
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Matthew W State
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Justin T Baker
- McLean Hospital Institute for Technology in Psychiatry, Belmont, MA, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Mental Illness Research Education and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| |
Collapse
|
28
|
Fang H, Yang Y. Predictive neuromodulation of cingulo-frontal neural dynamics in major depressive disorder using a brain-computer interface system: A simulation study. Front Comput Neurosci 2023; 17:1119685. [PMID: 36950505 PMCID: PMC10025398 DOI: 10.3389/fncom.2023.1119685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/15/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Deep brain stimulation (DBS) is a promising therapy for treatment-resistant major depressive disorder (MDD). MDD involves the dysfunction of a brain network that can exhibit complex nonlinear neural dynamics in multiple frequency bands. However, current open-loop and responsive DBS methods cannot track the complex multiband neural dynamics in MDD, leading to imprecise regulation of symptoms, variable treatment effects among patients, and high battery power consumption. Methods Here, we develop a closed-loop brain-computer interface (BCI) system of predictive neuromodulation for treating MDD. We first use a biophysically plausible ventral anterior cingulate cortex (vACC)-dorsolateral prefrontal cortex (dlPFC) neural mass model of MDD to simulate nonlinear and multiband neural dynamics in response to DBS. We then use offline system identification to build a dynamic model that predicts the DBS effect on neural activity. We next use the offline identified model to design an online BCI system of predictive neuromodulation. The online BCI system consists of a dynamic brain state estimator and a model predictive controller. The brain state estimator estimates the MDD brain state from the history of neural activity and previously delivered DBS patterns. The predictive controller takes the estimated MDD brain state as the feedback signal and optimally adjusts DBS to regulate the MDD neural dynamics to therapeutic targets. We use the vACC-dlPFC neural mass model as a simulation testbed to test the BCI system and compare it with state-of-the-art open-loop and responsive DBS treatments of MDD. Results We demonstrate that our dynamic model accurately predicts nonlinear and multiband neural activity. Consequently, the predictive neuromodulation system accurately regulates the neural dynamics in MDD, resulting in significantly smaller control errors and lower DBS battery power consumption than open-loop and responsive DBS. Discussion Our results have implications for developing future precisely-tailored clinical closed-loop DBS treatments for MDD.
Collapse
Affiliation(s)
- Hao Fang
- Department of Electrical and Computer Engineering, University of Central Florida, Orlando, FL, United States
| | - Yuxiao Yang
- Ministry of Education (MOE) Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University, Hangzhou, Zhejiang, China
- State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, Hangzhou, Zhejiang, China
- College of Computer Science and Technology, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- *Correspondence: Yuxiao Yang
| |
Collapse
|
29
|
Sonkusare S, Qiong D, Zhao Y, Liu W, Yang R, Mandali A, Manssuer L, Zhang C, Cao C, Sun B, Zhan S, Voon V. Frequency dependent emotion differentiation and directional coupling in amygdala, orbitofrontal and medial prefrontal cortex network with intracranial recordings. Mol Psychiatry 2022; 28:1636-1646. [PMID: 36460724 DOI: 10.1038/s41380-022-01883-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 12/04/2022]
Abstract
The amygdala, orbitofrontal cortex (OFC) and medial prefrontal cortex (mPFC) form a crucial part of the emotion circuit, yet their emotion induced responses and interactions have been poorly investigated with direct intracranial recordings. Such high-fidelity signals can uncover precise spectral dynamics and frequency differences in valence processing allowing novel insights on neuromodulation. Here, leveraging the unique spatio-temporal advantages of intracranial electroencephalography (iEEG) from a cohort of 35 patients with intractable epilepsy (with 71 contacts in amygdala, 31 in OFC and 43 in mPFC), we assessed the spectral dynamics and interactions between the amygdala, OFC and mPFC during an emotional picture viewing task. Task induced activity showed greater broadband gamma activity in the negative condition compared to positive condition in all the three regions. Similarly, beta activity was increased in the negative condition in the amygdala and OFC while decreased in mPFC. Furthermore, beta activity of amygdala showed significant negative association with valence ratings. Critically, model-based computational analyses revealed unidirectional connectivity from mPFC to the amygdala and bidirectional communication between OFC-amygdala and OFC-mPFC. Our findings provide direct neurophysiological evidence for a much-posited model of top-down influence of mPFC over amygdala and a bidirectional influence between OFC and the amygdala. Altogether, in a relatively large sample size with human intracranial neuronal recordings, we highlight valence-dependent spectral dynamics and dyadic coupling within the amygdala-mPFC-OFC network with implications for potential targeted neuromodulation in emotion processing.
Collapse
Affiliation(s)
- Saurabh Sonkusare
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Psychiatry, University of Cambridge, Cambridge, UK.,Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Ding Qiong
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Yijie Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Wei Liu
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruoqi Yang
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Alekhya Mandali
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK
| | - Luis Manssuer
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Psychiatry, University of Cambridge, Cambridge, UK.,Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunyan Cao
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shikun Zhan
- Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK. .,Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
| |
Collapse
|
30
|
Brain metabolic changes and clinical response to superolateral medial forebrain bundle deep brain stimulation for treatment-resistant depression. Mol Psychiatry 2022; 27:4561-4567. [PMID: 35982256 DOI: 10.1038/s41380-022-01726-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 12/14/2022]
Abstract
Deep brain stimulation (DBS) to the superolateral branch of the medial forebrain bundle is an efficacious therapy for treatment-resistant depression, providing rapid antidepressant effects. In this study, we use 18F-fluorodeoxyglucose-positron emission tomography (PET) to identify brain metabolic changes over 12 months post-DBS implantation in ten of our patients, compared to baseline. The primary outcome measure was a 50% reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) score, which was interpreted as a response. Deterministic fiber tracking was used to individually map the target area; probabilistic tractography was used to identify modulated fiber tracts modeled using the cathodal contacts. Eight of the ten patients included in this study were responders. PET imaging revealed significant decreases in bilateral caudate, mediodorsal thalamus, and dorsal anterior cingulate cortex metabolism that was evident at 6 months and continued to 12 months post surgery. At 12 months post-surgery, significant left ventral prefrontal cortical metabolic decreases were also observed. Right caudate metabolic decrease at 12 months was significantly correlated with mean MADRS reduction. Probabilistic tractography modeling revealed that such metabolic changes lay along cortico-limbic nodes structurally connected to the DBS target site. Such observed metabolic changes following DBS correlated with clinical response provide insights into how future studies can elaborate such data to create biomarkers to predict response, the development of which likely will require multimodal imaging analysis.
Collapse
|
31
|
Vatsyayan R, Dayeh SA. A universal model of electrochemical safety limits in vivo for electrophysiological stimulation. Front Neurosci 2022; 16:972252. [PMID: 36277998 PMCID: PMC9582612 DOI: 10.3389/fnins.2022.972252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/12/2022] [Indexed: 11/26/2022] Open
Abstract
Electrophysiological stimulation has been widely adopted for clinical diagnostic and therapeutic treatments for modulation of neuronal activity. Safety is a primary concern in an interventional design leveraging the effects of electrical charge injection into tissue in the proximity of target neurons. While modalities of tissue damage during stimulation have been extensively investigated for specific electrode geometries and stimulation paradigms, a comprehensive model that can predict the electrochemical safety limits in vivo doesn’t yet exist. Here we develop a model that accounts for the electrode geometry, inter-electrode separation, material, and stimulation paradigm in predicting safe current injection limits. We performed a parametric investigation of the stimulation limits in both benchtop and in vivo setups for flexible microelectrode arrays with low impedance, high geometric surface area platinum nanorods and PEDOT:PSS, and higher impedance, planar platinum contacts. We benchmark our findings against standard clinical electrocorticography and depth electrodes. Using four, three and two contact electrochemical impedance measurements and comprehensive circuit models derived from these measurements, we developed a more accurate, clinically relevant and predictive model for the electrochemical interface potential. For each electrode configuration, we experimentally determined the geometric correction factors that dictate geometry-enforced current spreading effects. We also determined the electrolysis window from cyclic-voltammetry measurements which allowed us to calculate stimulation current safety limits from voltage transient measurements. From parametric benchtop electrochemical measurements and analyses for different electrode types, we created a predictive equation for the cathodal excitation measured at the electrode interface as a function of the electrode dimensions, geometric factor, material and stimulation paradigm. We validated the accuracy of our equation in vivo and compared the experimentally determined safety limits to clinically used stimulation protocols. Our new model overcomes the design limitations of Shannon’s equation and applies to macro- and micro-electrodes at different density or separation of contacts, captures the breakdown of charge-density based approaches at long stimulation pulse widths, and invokes appropriate power exponents to current, pulse width, and material/electrode-dependent impedance.
Collapse
|
32
|
Nejati V, Heyrani R, Nitsche M. Attention bias modification through transcranial direct current stimulation (tDCS): A review. Neurophysiol Clin 2022; 52:341-353. [DOI: 10.1016/j.neucli.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/09/2022] [Accepted: 09/10/2022] [Indexed: 11/07/2022] Open
|
33
|
Zhang T, Zhang Q, Wu J, Wang M, Li W, Yan J, Zhang J, Jin Z, Li L. The critical role of the orbitofrontal cortex for regret in an economic decision-making task. Brain Struct Funct 2022; 227:2751-2767. [DOI: 10.1007/s00429-022-02568-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022]
|
34
|
Shao R, Gao M, Lin C, Huang CM, Liu HL, Toh CH, Wu C, Tsai YF, Qi D, Lee SH, Lee TMC. Multimodal Neural Evidence on the Corticostriatal Underpinning of Suicidality in Late-Life Depression. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:905-915. [PMID: 34861420 DOI: 10.1016/j.bpsc.2021.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/13/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Suicidality involves thoughts (ideations and plans) and actions related to self-inflicted death. To improve management and prevention of suicidality, it is essential to understand the key neural mechanisms underlying suicidal thoughts and actions. Following empirically informed neural framework, we hypothesized that suicidal thoughts would be primarily characterized by alterations in the default mode network indicating disrupted self-related processing, whereas suicidal actions would be characterized by changes in the lateral prefrontal corticostriatal circuitries implicating compromised action control. METHODS We analyzed the gray matter volume and resting-state functional connectivity of 113 individuals with late-life depression, including 45 nonsuicidal patients, 33 with suicidal thoughts but no action, and 35 with past suicidal action. Between-group analyses revealed key neural features associated with suicidality. The functional directionality of the identified resting-state functional connectivity was examined using dynamic causal modeling to further elucidate its mechanistic nature. Post hoc classification analysis examined the contribution of the neural measures to suicide classification. RESULTS As expected, reduced gray matter volumes in the default mode network and lateral prefrontal regions characterized patients with suicidal thoughts and those with past suicidal actions compared with nonsuicidal patients. Furthermore, region-of-interest analyses revealed that the directionality and strength of the ventrolateral prefrontal cortex-caudate resting-state functional connectivity were related to suicidal thoughts and actions. The neural features significantly improved classification of suicidal thoughts and actions over that based on clinical and suicide questionnaire variables. CONCLUSIONS Gray matter reductions in the default mode network and lateral prefrontal regions and the ventrolateral prefrontal cortex-caudate connectivity alterations characterized suicidal thoughts and actions in patients with late-life depression.
Collapse
Affiliation(s)
- Robin Shao
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology & Human Neuroscience, The University of Hong Kong, Hong Kong
| | - Mengxia Gao
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology & Human Neuroscience, The University of Hong Kong, Hong Kong
| | - Chemin Lin
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan County, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; Center for Intelligent Drug Systems and Smart Bio-devices, National Chiao Tung University, Taipei, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas M D Anderson Cancer Center, Houston, Texas
| | - Cheng-Hong Toh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Linkou, Taoyuan County, Taiwan
| | - Changwei Wu
- Brain and Consciousness Research Center, Shuang-Ho Hospital, New Taipei, Taiwan; Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Di Qi
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology & Human Neuroscience, The University of Hong Kong, Hong Kong
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan County, Taiwan.
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology & Human Neuroscience, The University of Hong Kong, Hong Kong; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China.
| |
Collapse
|
35
|
Mosilhy EA, Alshial EE, Eltaras MM, Rahman MMA, Helmy HI, Elazoul AH, Hamdy O, Mohammed HS. Non-invasive transcranial brain modulation for neurological disorders treatment: A narrative review. Life Sci 2022; 307:120869. [DOI: 10.1016/j.lfs.2022.120869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022]
|
36
|
Cecchi R, Vinckier F, Hammer J, Marusic P, Nica A, Rheims S, Trebuchon A, Barbeau EJ, Denuelle M, Maillard L, Minotti L, Kahane P, Pessiglione M, Bastin J. Intracerebral mechanisms explaining the impact of incidental feedback on mood state and risky choice. eLife 2022; 11:72440. [PMID: 35822700 PMCID: PMC9348847 DOI: 10.7554/elife.72440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Identifying factors whose fluctuations are associated with choice inconsistency is a major issue for rational decision theory. Here, we investigated the neuro-computational mechanisms through which mood fluctuations may bias human choice behavior. Intracerebral EEG data were collected in a large group of subjects (n=30) while they were performing interleaved quiz and choice tasks that were designed to examine how a series of unrelated feedbacks affect decisions between safe and risky options. Neural baseline activity preceding choice onset was confronted first to mood level, estimated by a computational model integrating the feedbacks received in the quiz task, and then to the weighting of option attributes, in a computational model predicting risk attitude in the choice task. Results showed that (1) elevated broadband gamma activity (BGA) in the ventromedial prefrontal cortex (vmPFC) and dorsal anterior insula (daIns) was respectively signaling periods of high and low mood, (2) increased vmPFC and daIns BGA respectively promoted and tempered risk taking by overweighting gain vs. loss prospects. Thus, incidental feedbacks induce brain states that correspond to different moods and bias the evaluation of risky options. More generally, these findings might explain why people experiencing positive (or negative) outcome in some part of their life tend to expect success (or failure) in any other.
Collapse
Affiliation(s)
| | | | - Jiri Hammer
- University Hospital in Motol, Prague, Czech Republic
| | - Petr Marusic
- University Hospital in Motol, Prague, Czech Republic
| | - Anca Nica
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | | | | | - Emmanuel J Barbeau
- Brain and Cognition Research Centre (CerCo), CNRS, University of Toulouse Paul Sabatier, Toulouse, France
| | - Marie Denuelle
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | | | - Lorella Minotti
- Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Philippe Kahane
- Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | | | | |
Collapse
|
37
|
Sydnor VJ, Cieslak M, Duprat R, Deluisi J, Flounders MW, Long H, Scully M, Balderston NL, Sheline YI, Bassett DS, Satterthwaite TD, Oathes DJ. Cortical-subcortical structural connections support transcranial magnetic stimulation engagement of the amygdala. SCIENCE ADVANCES 2022; 8:eabn5803. [PMID: 35731882 PMCID: PMC9217085 DOI: 10.1126/sciadv.abn5803] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/04/2022] [Indexed: 05/31/2023]
Abstract
The amygdala processes valenced stimuli, influences emotion, and exhibits aberrant activity across anxiety disorders, depression, and PTSD. Interventions modulating amygdala activity hold promise as transdiagnostic psychiatric treatments. In 45 healthy participants, we investigated whether transcranial magnetic stimulation (TMS) elicits indirect changes in amygdala activity when applied to ventrolateral prefrontal cortex (vlPFC), a region important for emotion regulation. Harnessing in-scanner interleaved TMS/functional MRI (fMRI), we reveal that vlPFC neurostimulation evoked acute and focal modulations of amygdala fMRI BOLD signal. Larger TMS-evoked changes in the amygdala were associated with higher fiber density in a vlPFC-amygdala white matter pathway when stimulating vlPFC but not an anatomical control, suggesting this pathway facilitated stimulation-induced communication between cortex and subcortex. This work provides evidence of amygdala engagement by TMS, highlighting stimulation of vlPFC-amygdala circuits as a candidate treatment for transdiagnostic psychopathology. More broadly, it indicates that targeting cortical-subcortical structural connections may enhance the impact of TMS on subcortical neural activity and, by extension, subcortex-subserved behaviors.
Collapse
Affiliation(s)
- Valerie J. Sydnor
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Matthew Cieslak
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Romain Duprat
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Joseph Deluisi
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Matthew W. Flounders
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hannah Long
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Morgan Scully
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Nicholas L. Balderston
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yvette I. Sheline
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dani S. Bassett
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Electrical and Systems Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Physics and Astronomy, College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Santa Fe Institute, Santa Fe, NM 87501, USA
| | - Theodore D. Satterthwaite
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Desmond J. Oathes
- Center for Neuromodulation in Depression and Stress (CNDS), Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Penn Brain Science, Translation, Innovation, and Modulation Center (brainSTIM), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| |
Collapse
|
38
|
Zhang X, Zhang H, Lin Z, Barbosa DAN, Lai Y, Halpern CH, Voon V, Li D, Zhang C, Sun B. Effects of Bilateral Subthalamic Nucleus Stimulation on Depressive Symptoms and Cerebral Glucose Metabolism in Parkinson's Disease: A 18F-Fluorodeoxyglucose Positron Emission Tomography/Computerized Tomography Study. Front Neurosci 2022; 16:843667. [PMID: 35720690 PMCID: PMC9200334 DOI: 10.3389/fnins.2022.843667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 03/10/2022] [Indexed: 02/02/2023] Open
Abstract
Subthalamic nucleus (STN) deep brain stimulation (DBS) can improve motor symptoms in Parkinson's disease (PD), as well as potentially improving otherwise intractable comorbid depressive symptoms. To address the latter issue, we evaluated the severity of depressive symptoms along with the severity of motor symptoms in 18 PD patients (mean age, 58.4 ± 5.4 years; 9 males, 9 females; mean PD duration, 9.4 ± 4.4 years) with treatment-resistant depression (TRD) before and after approximately 1 year of STN-DBS treatment. Moreover, to gain more insight into the brain mechanism mediating the therapeutic action of STN-DBS, we utilized 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) to assess cerebral regional glucose metabolism in the patients at baseline and 1-year follow-up. Additionally, the baseline PET data from patients were compared with PET data from an age- and sex-matched control group of 16 healthy volunteers. Among them, 12 PD patients underwent post-operative follow-up PET scans. Results showed that the severity of both motor and depressive symptoms in patients with PD-TRD was reduced significantly at 1-year follow-up. Also, patients used significantly less antiparkinsonian medications and antidepressants at 1-year follow-up, as well as experiencing improved daily functioning and a better quality of life. Moreover, relative to the PET data from healthy controls, PD-TRD patients displayed widespread abnormalities in cerebral regional glucose metabolism before STN-DBS treatment, which were partially recovered at 1-year follow-up. Additionally, significant correlations were observed between the patients' improvements in depressive symptoms following STN-DBS and post-operative changes in glucose metabolism in brain regions implicated in emotion regulation. These results support the view that STN-DBS provides a promising treatment option for managing both motor and depressive symptoms in patients who suffer from PD with TRD. However, the results should be interpreted with caution due to the observational nature of the study, small sample size, and relatively short follow-up.
Collapse
Affiliation(s)
- Xiaoxiao Zhang
- Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Huiwei Zhang
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhengyu Lin
- Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Daniel A. N. Barbosa
- Department of Neurosurgery, School of Medicine, Stanford University, Stanford, CA, United States
| | - Yijie Lai
- Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Casey H. Halpern
- Department of Neurosurgery, School of Medicine, Stanford University, Stanford, CA, United States
| | - Valerie Voon
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Dianyou Li
- Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Chencheng Zhang,
| | - Bomin Sun
- Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,Bomin Sun,
| |
Collapse
|
39
|
Ehrlich TJ, Bhat J, Horwege AM, Mathalon DH, Glover GH, Roach BJ, Badran BW, Forman SD, George MS, Scott JC, Thase ME, Yesavage JA, Yurgelun-Todd DA, Rosen AC. Ruminative reflection is associated with anticorrelations between the orbitofrontal cortex and the default mode network in depression: implications for repetitive transcranial magnetic stimulation. Brain Imaging Behav 2022; 16:1186-1195. [PMID: 34860349 PMCID: PMC9107429 DOI: 10.1007/s11682-021-00596-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 02/01/2023]
Abstract
Patients with depression who ruminate repeatedly focus on depressive thoughts; however, there are two cognitive subtypes of rumination, reflection and brooding, each associated with different prognoses. Reflection involves problem-solving and is associated with positive outcomes, whereas brooding involves passive, negative, comparison with other people and is associated with poor outcomes. Rumination has also been related to atypical functional hyperconnectivity between the default mode network and subgenual prefrontal cortex. Repetitive pulse transcranial magnetic stimulation of the prefrontal cortex has been shown to alter functional connectivity, suggesting that the abnormal connectivity associated with rumination could potentially be altered. This study examined potential repetitive pulse transcranial magnetic stimulation prefrontal cortical targets that could modulate one or both of these rumination subtypes. Forty-three patients who took part in a trial of repetitive pulse transcranial magnetic stimulation completed the Rumination Response Scale questionnaire and resting-state functional magnetic resonance imaging. Seed to voxel functional connectivity analyses identified an anticorrelation between the left lateral orbitofrontal cortex (-44, 26, -8; k = 172) with the default mode network-subgenual region in relation to higher levels of reflection. Parallel analyses were not significant for brooding or the RRS total score. These findings extend previous studies of rumination and identify a potential mechanistic model for symptom-based neuromodulation of rumination.
Collapse
Affiliation(s)
- Tobin J Ehrlich
- Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (151Y), Palo Alto, CA, 94304, USA
- University of Michigan, Ann Arbor, MI, USA
| | - Jyoti Bhat
- Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (151Y), Palo Alto, CA, 94304, USA
- Palo Alto Veterans Institute for Research, Palo Alto, CA, 94304, USA
| | - Andrea M Horwege
- Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (151Y), Palo Alto, CA, 94304, USA
| | - Daniel H Mathalon
- Mental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Gary H Glover
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Brian J Roach
- Mental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, USA
| | - Bashar W Badran
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Steven D Forman
- Department of Veterans Affairs, Veterans Affairs Medical Center, Pittsburgh, PA, USA
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mark S George
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - J Cobb Scott
- VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael E Thase
- VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jerome A Yesavage
- Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (151Y), Palo Alto, CA, 94304, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Deborah A Yurgelun-Todd
- Rocky Mountain Network Mental Illness Research Education and Clinical Centers (VISN 19), VA Salt Lake City Health Care System, Salt Lake City, UT, USA
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Allyson C Rosen
- Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (151Y), Palo Alto, CA, 94304, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| |
Collapse
|
40
|
Fenoy AJ, Schulz PE, Sanches M, Selvaraj S, Burrows CL, Asir B, Conner CR, Quevedo J, Soares JC. Deep brain stimulation of the "medial forebrain bundle": sustained efficacy of antidepressant effect over years. Mol Psychiatry 2022; 27:2546-2553. [PMID: 35288633 DOI: 10.1038/s41380-022-01504-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022]
Abstract
Deep brain stimulation (DBS) to the superolateral branch of the medial forebrain bundle (MFB) has emerged as a quite efficacious therapy for treatment resistant depression (TRD), leading to rapid antidepressant effects. In this study, we complete our assessment of our first 10 enrolled patients throughout one year post-implantation, showing sustained antidepressant effect up to 5 years. The primary outcome measure was a 50% reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) score, which was interpreted as a response. Deterministic fiber tracking was used to individually map the target area. An insertional effect was seen during the 4-week sham stimulation phase (29% mean MADRS reduction, p = 0.02). However, after 2 weeks of initiating stimulation, five patients met response criteria (47% mean MADRS reduction, p < 0.001). One patient withdrew from study participation at 6 weeks. Twelve weeks after initiating stimulation, six of nine remaining patients had a >50% decrease in MADRS scores relative to baseline (52% mean MADRS reduction, p = 0.001); these same six patients continued to meet response criteria at 52 weeks (63% overall mean MADRS reduction, p < 0.001). Four of five patients who achieved the 5-year time point analysis continued to be responders (81% mean MADRS reduction, p < 0.001). Evaluation of modulated fiber tracts reveals significant common prefrontal/orbitofrontal connectivity to the target region in all responders. Key points learned from this study that we can incorporate in future protocols to better elucidate the effect of this therapy are a longer blinded sham stimulation phase and use of scheduled discontinuation concomitant with functional imaging.
Collapse
Affiliation(s)
- Albert J Fenoy
- Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA. .,Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, (UT Health), Houston, TX, USA.
| | - Paul E Schulz
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA
| | - Marsal Sanches
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, (UT Health), Houston, TX, USA
| | - Sudhakar Selvaraj
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, (UT Health), Houston, TX, USA
| | - Christina L Burrows
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA
| | - Bashar Asir
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, (UT Health), Houston, TX, USA
| | - Christopher R Conner
- Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA
| | - Joao Quevedo
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, (UT Health), Houston, TX, USA
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, (UT Health), Houston, TX, USA
| |
Collapse
|
41
|
Large-scale structural network change correlates with clinical response to rTMS in depression. Neuropsychopharmacology 2022; 47:1096-1105. [PMID: 35110687 PMCID: PMC8938539 DOI: 10.1038/s41386-021-01256-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/06/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Abstract
Response to repetitive transcranial magnetic stimulation (rTMS) among individuals with major depressive disorder (MDD) varies widely. The neural mechanisms underlying rTMS are thought to involve changes in large-scale networks. Whether structural network integrity and plasticity are associated with response to rTMS therapy is unclear. Structural MRIs were acquired from a series of 70 adult healthy controls and 268 persons with MDD who participated in two arms of a large randomized, non-inferiority trial, THREE-D, comparing intermittent theta-burst stimulation to high-frequency rTMS of the left dorsolateral prefrontal cortex (DLPFC). Patients were grouped according to percentage improvement on the 17-item Hamilton Depression Rating Score at treatment completion. For the entire sample and then for each treatment arm, multivariate analyses were used to characterize structural covariance networks (SCN) from cortical gray matter thickness, volume, and surface area maps from T1-weighted MRI. The association between SCNs and clinical improvement was assessed. For both study arms, cortical thickness and volume SCNs distinguished healthy controls from MDD (p = 0.005); however, post-hoc analyses did not reveal a significant association between pre-treatment SCN expression and clinical improvement. We also isolated an anticorrelated SCN between the left DLPFC rTMS target site and the subgenual anterior cingulate cortex across cortical measures (p = 0.0004). Post-treatment change in cortical thickness SCN architecture was associated with clinical improvement in treatment responders (p = 0.001), but not in non-responders. Structural network changes may underpin clinical response to rTMS, and SCNs are useful for understanding the pathophysiology of depression and neural mechanisms of plasticity and response to circuit-based treatments.
Collapse
|
42
|
Dorsomedial prefrontal rTMS for depression in borderline personality disorder: A pilot randomized crossover trial. J Affect Disord 2022; 301:273-280. [PMID: 34942227 DOI: 10.1016/j.jad.2021.12.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/20/2021] [Accepted: 12/18/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Recently, a small literature has emerged suggesting that repetitive transcranial magnetic stimulation (rTMS) may offer benefit for MDD even in BPD patients, perhaps by enhancing cognitive control, and/or disrupting excessive 'non-reward' activity in right orbitofrontal regions. This study aimed primarily to assess the therapeutic effects of dorsomedial prefrontal cortex (DMPFC)-rTMS against MDD symptoms in BPD patients, and secondarily to assess whether the therapeutic effects ensued via mechanisms of reduced impulsivity and core BPD pathology on clinical scales (BIS-11, ZAN-BPD) or of reduced alpha- and theta-band activity on EEG recordings of right orbitofrontal cortex.. METHODS In a crossover-design trial, 20 BPD patients with MDD underwent 2 × 30 session/15 day blocks of either active-then-sham or sham-then-active bilateral 20 Hz DMPFC-rTMS. RESULTS Sixteen out of 20 patients completed treatment. A significant (p = 0.00764) crossover effect was detected, with overall reductions in HamD17 score from 23.1±SD3.1 to 10.75±SD5.8. Nine out of 16 (56.3%) treatment completers achieved response (>50% improvement) and 6/16 (37.5%) achieved remission (HamD≤7), maintained at 1 month followup. BIS-11 scores remained unchanged, and ZAN-BPD scores improved similarly in both groups with no significant crossover effect. Change in low-band power over right orbitofrontal regions correlated with clinical improvement. LIMITATIONS This was a crossover study with a small sample size. A randomized controlled trial with larger sample size will be needed to establish the efficacy more definitively. CONCLUSIONS The results suggest efficacy for DMPFC-rTMS in treating MDD in BPD, and provide a foundation for a larger future trial.
Collapse
|
43
|
Bijanzadeh M, Khambhati AN, Desai M, Wallace DL, Shafi A, Dawes HE, Sturm VE, Chang EF. Decoding naturalistic affective behaviour from spectro-spatial features in multiday human iEEG. Nat Hum Behav 2022; 6:823-836. [PMID: 35273355 DOI: 10.1038/s41562-022-01310-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 01/18/2022] [Indexed: 02/04/2023]
Abstract
The neurological basis of affective behaviours in everyday life is not well understood. We obtained continuous intracranial electroencephalography recordings from the human mesolimbic network in 11 participants with epilepsy and hand-annotated spontaneous behaviours from 116 h of multiday video recordings. In individual participants, binary random forest models decoded affective behaviours from neutral behaviours with up to 93% accuracy. Both positive and negative affective behaviours were associated with increased high-frequency and decreased low-frequency activity across the mesolimbic network. The insula, amygdala, hippocampus and anterior cingulate cortex made stronger contributions to affective behaviours than the orbitofrontal cortex, but the insula and anterior cingulate cortex were most critical for differentiating behaviours with observable affect from those without. In a subset of participants (N = 3), multiclass decoders distinguished amongst the positive, negative and neutral behaviours. These results suggest that spectro-spatial features of brain activity in the mesolimbic network are associated with affective behaviours of everyday life.
Collapse
Affiliation(s)
- Maryam Bijanzadeh
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Ankit N Khambhati
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Maansi Desai
- Department of Communication Sciences and Disorders, Moody College of Communication, University of Texas at Austin, Austin, TX, USA
| | - Deanna L Wallace
- Department of Mechanical Engineering, Psychology and Neurology, University of Texas at Austin, Austin, TX, USA
| | - Alia Shafi
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Heather E Dawes
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Virginia E Sturm
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Edward F Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
| |
Collapse
|
44
|
Paulk AC, Zelmann R, Crocker B, Widge AS, Dougherty DD, Eskandar EN, Weisholtz DS, Richardson RM, Cosgrove GR, Williams ZM, Cash SS. Local and distant cortical responses to single pulse intracranial stimulation in the human brain are differentially modulated by specific stimulation parameters. Brain Stimul 2022; 15:491-508. [PMID: 35247646 PMCID: PMC8985164 DOI: 10.1016/j.brs.2022.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Electrical neuromodulation via direct electrical stimulation (DES) is an increasingly common therapy for a wide variety of neuropsychiatric diseases. Unfortunately, therapeutic efficacy is inconsistent, likely due to our limited understanding of the relationship between the massive stimulation parameter space and brain tissue responses. OBJECTIVE To better understand how different parameters induce varied neural responses, we systematically examined single pulse-induced cortico-cortico evoked potentials (CCEP) as a function of stimulation amplitude, duration, brain region, and whether grey or white matter was stimulated. METHODS We measured voltage peak amplitudes and area under the curve (AUC) of intracranially recorded stimulation responses as a function of distance from the stimulation site, pulse width, current injected, location relative to grey and white matter, and brain region stimulated (N = 52, n = 719 stimulation sites). RESULTS Increasing stimulation pulse width increased responses near the stimulation location. Increasing stimulation amplitude (current) increased both evoked amplitudes and AUC nonlinearly. Locally (<15 mm), stimulation at the boundary between grey and white matter induced larger responses. In contrast, for distant sites (>15 mm), white matter stimulation consistently produced larger responses than stimulation in or near grey matter. The stimulation location-response curves followed different trends for cingulate, lateral frontal, and lateral temporal cortical stimulation. CONCLUSION These results demonstrate that a stronger local response may require stimulation in the grey-white boundary while stimulation in the white matter could be needed for network activation. Thus, stimulation parameters tailored for a specific anatomical-functional outcome may be key to advancing neuromodulatory therapy.
Collapse
Affiliation(s)
- Angelique C Paulk
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | - Rina Zelmann
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Britni Crocker
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Harvard-MIT Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Darin D Dougherty
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Emad N Eskandar
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Daniel S Weisholtz
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - R Mark Richardson
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - Ziv M Williams
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
45
|
Voetterl H, Miron JP, Mansouri F, Fox L, Hyde M, Blumberger DM, Daskalakis ZJ, Vila-Rodriguez F, Sack AT, Downar J. Investigating EEG biomarkers of clinical response to low frequency rTMS in depression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
46
|
Human intracranial recordings reveal distinct cortical activity patterns during invasive and non-invasive vagus nerve stimulation. Sci Rep 2021; 11:22780. [PMID: 34815529 PMCID: PMC8611055 DOI: 10.1038/s41598-021-02307-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/12/2021] [Indexed: 12/26/2022] Open
Abstract
Vagus nerve stimulation (VNS) is being used increasingly to treat a wide array of diseases and disorders. This growth is driven in part by the putative ability to stimulate the nerve non-invasively. Despite decades of use and a rapidly expanding application space, we lack a complete understanding of the acute effects of VNS on human cortical neurophysiology. Here, we investigated cortical responses to sub-perceptual threshold cervical implanted (iVNS) and transcutaneous auricular (taVNS) vagus nerve stimulation using intracranial neurophysiological recordings in human epilepsy patients. To understand the areas that are modulated by VNS and how they differ depending on invasiveness and stimulation parameters, we compared VNS-evoked neural activity across a range of stimulation modalities, frequencies, and amplitudes. Using comparable stimulation parameters, both iVNS and taVNS caused subtle changes in low-frequency power across broad cortical networks, which were not the same across modalities and were highly variable across participants. However, within at least some individuals, it may be possible to elicit similar responses across modalities using distinct sets of stimulation parameters. These results demonstrate that both invasive and non-invasive VNS cause evoked changes in activity across a set of highly distributed cortical networks that are relevant to a diverse array of clinical, rehabilitative, and enhancement applications.
Collapse
|
47
|
Using Brain Imaging to Improve Spatial Targeting of Transcranial Magnetic Stimulation for Depression. Biol Psychiatry 2021; 90:689-700. [PMID: 32800379 DOI: 10.1016/j.biopsych.2020.05.033] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 01/18/2023]
Abstract
Transcranial magnetic stimulation (TMS) is an effective treatment for depression but is limited in that the optimal therapeutic target remains unknown. Early TMS trials lacked a focal target and thus positioned the TMS coil over the prefrontal cortex using scalp measurements. Over time, it became clear that this method leads to variation in the stimulation site and that this could contribute to heterogeneity in antidepressant response. Newer methods allow for precise positioning of the TMS coil over a specific brain location, but leveraging these precise methods requires a more precise therapeutic target. We review how neuroimaging is being used to identify a more focal therapeutic target for depression. We highlight recent studies showing that more effective TMS targets in the frontal cortex are functionally connected to deep limbic regions such as the subgenual cingulate cortex. We review how connectivity might be used to identify an optimal TMS target for use in all patients and potentially even a personalized target for each individual patient. We address the clinical implications of this emerging field and highlight critical questions for future research.
Collapse
|
48
|
de Hemptinne C, Chen W, Racine CA, Seritan AL, Miller AM, Yaroshinsky MS, Wang SS, Gilron R, Little S, Bledsoe I, San Luciano M, Katz M, Chang EF, Dawes HE, Ostrem JL, Starr PA. Prefrontal Physiomarkers of Anxiety and Depression in Parkinson's Disease. Front Neurosci 2021; 15:748165. [PMID: 34744613 PMCID: PMC8568318 DOI: 10.3389/fnins.2021.748165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/17/2021] [Indexed: 11/19/2022] Open
Abstract
Objective: Anxiety and depression are prominent non-motor symptoms of Parkinson’s disease (PD), but their pathophysiology remains unclear. We sought to understand their neurophysiological correlates from chronic invasive recordings of the prefrontal cortex (PFC). Methods: We studied four patients undergoing deep brain stimulation (DBS) for their motor signs, who had comorbid mild to moderate anxiety and/or depressive symptoms. In addition to their basal ganglia leads, we placed a permanent prefrontal subdural 4-contact lead. These electrodes were attached to an investigational pulse generator with the capability to sense and store field potential signals, as well as deliver therapeutic neurostimulation. At regular intervals over 3–5 months, participants paired brief invasive neural recordings with self-ratings of symptoms related to depression and anxiety. Results: Mean age was 61 ± 7 years, mean disease duration was 11 ± 8 years and a mean Unified Parkinson’s Disease Rating Scale, with part III (UPDRS-III) off medication score of 37 ± 13. Mean Beck Depression Inventory (BDI) score was 14 ± 5 and Beck Anxiety Index was 16.5 ± 5. Prefrontal cortex spectral power in the beta band correlated with patient self-ratings of symptoms of depression and anxiety, with r-values between 0.31 and 0.48. Mood scores showed negative correlation with beta spectral power in lateral locations, and positive correlation with beta spectral power in a mesial recording location, consistent with the dichotomous organization of reward networks in PFC. Interpretation: These findings suggest a physiological basis for anxiety and depression in PD, which may be useful in the development of neurostimulation paradigms for these non-motor disease features.
Collapse
Affiliation(s)
- Coralie de Hemptinne
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Witney Chen
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Caroline A Racine
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Andreea L Seritan
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew M Miller
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Maria S Yaroshinsky
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Sarah S Wang
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Roee Gilron
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Simon Little
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Ian Bledsoe
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Marta San Luciano
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Maya Katz
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Heather E Dawes
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jill L Ostrem
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Philip A Starr
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
49
|
Ong SK, Husain SF, Wee HN, Ching J, Kovalik JP, Cheng MS, Schwarz H, Tang TB, Ho CS. Integration of the Cortical Haemodynamic Response Measured by Functional Near-Infrared Spectroscopy and Amino Acid Analysis to Aid in the Diagnosis of Major Depressive Disorder. Diagnostics (Basel) 2021; 11:diagnostics11111978. [PMID: 34829325 PMCID: PMC8617819 DOI: 10.3390/diagnostics11111978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Major depressive disorder (MDD) is a debilitating condition with a high disease burden and medical comorbidities. There are currently few to no validated biomarkers to guide the diagnosis and treatment of MDD. In the present study, we evaluated the differences between MDD patients and healthy controls (HCs) in terms of cortical haemodynamic responses during a verbal fluency test (VFT) using functional near-infrared spectroscopy (fNIRS) and serum amino acid profiles, and ascertained if these parameters were correlated with clinical characteristics. Methods: Twenty-five (25) patients with MDD and 25 age-, gender-, and ethnicity-matched HCs were recruited for the study. Real-time monitoring of the haemodynamic response during completion of a VFT was quantified using a 52-channel NIRS system. Serum samples were analysed and quantified by liquid chromatography-mass spectrometry for amino acid profiling. Receiver-operating characteristic (ROC) curves were used to classify potential candidate biomarkers. Results: The MDD patients had lower prefrontal and temporal activation during completion of the VFT than HCs. The MDD patients had lower mean concentrations of oxy-Hb in the left orbitofrontal cortex (OFC), and lower serum histidine levels. When the oxy-haemoglobin response was combined with the histidine concentration, the sensitivity and specificity of results improved significantly from 66.7% to 73.3% and from 65.0% to 90.0% respectively, as compared to results based only on the NIRS response. Conclusions: These findings demonstrate the use of combination biomarkers to aid in the diagnosis of MDD. This technique could be a useful approach to detect MDD with greater precision, but additional studies are required to validate the methodology.
Collapse
Affiliation(s)
- Samantha K. Ong
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Syeda F. Husain
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119276, Singapore;
| | - Hai Ning Wee
- Cardiovascular and Metabolic Disorders Programme, Duke-NUS Graduate Medical School, Singapore 169609, Singapore; (H.N.W.); (J.C.); (J.-P.K.)
| | - Jianhong Ching
- Cardiovascular and Metabolic Disorders Programme, Duke-NUS Graduate Medical School, Singapore 169609, Singapore; (H.N.W.); (J.C.); (J.-P.K.)
| | - Jean-Paul Kovalik
- Cardiovascular and Metabolic Disorders Programme, Duke-NUS Graduate Medical School, Singapore 169609, Singapore; (H.N.W.); (J.C.); (J.-P.K.)
| | - Man Si Cheng
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore; (M.S.C.); (H.S.)
| | - Herbert Schwarz
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore; (M.S.C.); (H.S.)
| | - Tong Boon Tang
- Centre for Intelligent Signal and Imaging Research (CISIR), University Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia;
| | - Cyrus S. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Correspondence: ; Tel.: +65-67795555
| |
Collapse
|
50
|
Scangos KW, Khambhati AN, Daly PM, Makhoul GS, Sugrue LP, Zamanian H, Liu TX, Rao VR, Sellers KK, Dawes HE, Starr PA, Krystal AD, Chang EF. Closed-loop neuromodulation in an individual with treatment-resistant depression. Nat Med 2021; 27:1696-1700. [PMID: 34608328 PMCID: PMC11219029 DOI: 10.1038/s41591-021-01480-w] [Citation(s) in RCA: 182] [Impact Index Per Article: 60.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/23/2021] [Indexed: 11/09/2022]
Abstract
Deep brain stimulation is a promising treatment for neuropsychiatric conditions such as major depression. It could be optimized by identifying neural biomarkers that trigger therapy selectively when symptom severity is elevated. We developed an approach that first used multi-day intracranial electrophysiology and focal electrical stimulation to identify a personalized symptom-specific biomarker and a treatment location where stimulation improved symptoms. We then implanted a chronic deep brain sensing and stimulation device and implemented a biomarker-driven closed-loop therapy in an individual with depression. Closed-loop therapy resulted in a rapid and sustained improvement in depression. Future work is required to determine if the results and approach of this n-of-1 study generalize to a broader population.
Collapse
Affiliation(s)
- Katherine W Scangos
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA.
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
| | - Ankit N Khambhati
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | - Patrick M Daly
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Ghassan S Makhoul
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Leo P Sugrue
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | - Hashem Zamanian
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Tony X Liu
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Vikram R Rao
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Kristin K Sellers
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | - Heather E Dawes
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | - Philip A Starr
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew D Krystal
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Edward F Chang
- Weill Institute for Neurosciences, University of California, San Francsico, CA, USA
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|