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Furman BW, Craighead WE, Mayberg HS, Mletzko T, Nemeroff CB, Dunlop BW. The utility of measuring daily hassles and uplifts in understanding outcomes to treatments for major depressive disorder. Psychiatry Res 2024; 335:115859. [PMID: 38574700 PMCID: PMC11015958 DOI: 10.1016/j.psychres.2024.115859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/09/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
Little is known about the effects of common daily experiences in patients with major depressive disorder (MDD). The Daily Hassles and Uplifts Scale (HUPS) was assessed in 142 treatment-naïve adult MDD outpatients randomized to 12 weeks of treatment with either antidepressant medication (ADM) or Cognitive Behavior Therapy (CBT). Three HUPS measures were analyzed: hassle frequency (HF), uplift frequency (UF), and the mean hassle intensity to mean uplift intensity ratio (MHI:MUI). Remission after treatment was not predicted by these baseline HUPS measures and did not moderate outcomes by treatment type. In contrast, HUPS measures significantly changed with treatment and were impacted by remission status. Specifically, HF and MHI:MUI decreased and UF increased from baseline to week 12, with remission leading to significantly greater decreases in HF and MHI:MUI compared to non-remission. ADM-treated patients demonstrated significant improvements on all three HUPS measures regardless of remission status. In contrast, remitters to CBT demonstrated significant improvements in HF and MHI:MUI but not UF; among CBT non-remitters the only significant change was a reduction in HF. The changes in HUPS measures are consistent with how affective biases are impacted by treatments and support the potential value of increasing attention to positive events in CBT.
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Affiliation(s)
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA; Department of Psychology, Emory University, Atlanta, USA
| | - Helen S Mayberg
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Tanja Mletzko
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA.
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2
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Bhattacharyya S, MahmoudianDehkordi S, Sniatynski MJ, Belenky M, Marur VR, Rush AJ, Craighead WE, Mayberg HS, Dunlop BW, Kristal BS, Kaddurah-Daouk R. Metabolomics Signatures of serotonin reuptake inhibitor (Escitalopram), serotonin norepinephrine reuptake inhibitor (Duloxetine) and Cognitive Behavior Therapy on Key Neurotransmitter Pathways in Major Depressive Disorder. medRxiv 2024:2024.04.02.24304677. [PMID: 38633777 PMCID: PMC11023644 DOI: 10.1101/2024.04.02.24304677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Metabolomics provides powerful tools that can inform about heterogeneity in disease and response to treatments. In this study, we employed an electrochemistry-based targeted metabolomics platform to assess the metabolic effects of three randomly-assigned treatments: escitalopram, duloxetine, and Cognitive Behavior Therapy (CBT) in 163 treatment-naïve outpatients with major depressive disorder. Serum samples from baseline and 12 weeks post-treatment were analyzed using targeted liquid chromatography-electrochemistry for metabolites related to tryptophan, tyrosine metabolism and related pathways. Changes in metabolite concentrations related to each treatment arm were identified and compared to define metabolic signatures of exposure. In addition, association between metabolites and depressive symptom severity (assessed with the 17-item Hamilton Rating Scale for Depression [HRSD17]) and anxiety symptom severity (assessed with the 14-item Hamilton Rating Scale for Anxiety [HRSA14]) were evaluated, both at baseline and after 12 weeks of treatment. Significant reductions in serum serotonin level and increases in tryptophan-derived indoles that are gut bacterially derived were observed with escitalopram and duloxetine arms but not in CBT arm. These include indole-3-propionic acid (I3PA), indole-3-lactic acid (I3LA) and Indoxyl sulfate (IS), a uremic toxin. Purine-related metabolites were decreased across all arms. Different metabolites correlated with improved symptoms in the different treatment arms revealing potentially different mechanisms between response to antidepressant medications and to CBT.
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Affiliation(s)
- Sudeepa Bhattacharyya
- Department of Biological Sciences, Arkansas Biosciences Institute, Arkansas State University, Jonesboro, AR, United States
| | | | - Matthew J Sniatynski
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, LM322B, Boston, MA 02115, USA and Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Marina Belenky
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, LM322B, Boston, MA 02115, USA and Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Vasant R Marur
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, LM322B, Boston, MA 02115, USA and Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - A John Rush
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States
- Duke-National University of Singapore, Singapore, Singapore
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Helen S Mayberg
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Bruce S Kristal
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, LM322B, Boston, MA 02115, USA and Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States
- Department of Medicine, Duke University, Durham, NC, United States
- Duke Institute of Brain Sciences, Duke University, Durham, NC, United States
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3
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Seas A, Noor MS, Choi KS, Veerakumar A, Obatusin M, Dahill-Fuchel J, Tiruvadi V, Xu E, Riva-Posse P, Rozell CJ, Mayberg HS, McIntyre CC, Waters AC, Howell B. Subcallosal cingulate deep brain stimulation evokes two distinct cortical responses via differential white matter activation. Proc Natl Acad Sci U S A 2024; 121:e2314918121. [PMID: 38527192 PMCID: PMC10998591 DOI: 10.1073/pnas.2314918121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/20/2024] [Indexed: 03/27/2024] Open
Abstract
Subcallosal cingulate (SCC) deep brain stimulation (DBS) is an emerging therapy for refractory depression. Good clinical outcomes are associated with the activation of white matter adjacent to the SCC. This activation produces a signature cortical evoked potential (EP), but it is unclear which of the many pathways in the vicinity of SCC is responsible for driving this response. Individualized biophysical models were built to achieve selective engagement of two target bundles: either the forceps minor (FM) or cingulum bundle (CB). Unilateral 2 Hz stimulation was performed in seven patients with treatment-resistant depression who responded to SCC DBS, and EPs were recorded using 256-sensor scalp electroencephalography. Two distinct EPs were observed: a 120 ms symmetric response spanning both hemispheres and a 60 ms asymmetrical EP. Activation of FM correlated with the symmetrical EPs, while activation of CB was correlated with the asymmetrical EPs. These results support prior model predictions that these two pathways are predominantly activated by clinical SCC DBS and provide first evidence of a link between cortical EPs and selective fiber bundle activation.
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Affiliation(s)
- Andreas Seas
- Department of Biomedical Engineering, Duke University, Durham, NC27708
- Department of Neurosurgery, Duke University, Durham, NC27708
| | - M. Sohail Noor
- Department of Biomedical Engineering, Duke University, Durham, NC27708
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH10900
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY10029
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA30329
| | - Ashan Veerakumar
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA30329
| | - Mosadoluwa Obatusin
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY10029
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA30329
| | - Jacob Dahill-Fuchel
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY10029
| | - Vineet Tiruvadi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA30329
| | - Elisa Xu
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY10029
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA30329
| | - Christopher J. Rozell
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA30332
| | - Helen S. Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY10029
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA30329
| | - Cameron C. McIntyre
- Department of Biomedical Engineering, Duke University, Durham, NC27708
- Department of Neurosurgery, Duke University, Durham, NC27708
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH10900
| | - Allison C. Waters
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY10029
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA30329
| | - Bryan Howell
- Department of Biomedical Engineering, Duke University, Durham, NC27708
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH10900
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4
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Batten SR, Bang D, Kopell BH, Davis AN, Heflin M, Fu Q, Perl O, Ziafat K, Hashemi A, Saez I, Barbosa LS, Twomey T, Lohrenz T, White JP, Dayan P, Charney AW, Figee M, Mayberg HS, Kishida KT, Gu X, Montague PR. Dopamine and serotonin in human substantia nigra track social context and value signals during economic exchange. Nat Hum Behav 2024; 8:718-728. [PMID: 38409356 PMCID: PMC11045309 DOI: 10.1038/s41562-024-01831-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024]
Abstract
Dopamine and serotonin are hypothesized to guide social behaviours. In humans, however, we have not yet been able to study neuromodulator dynamics as social interaction unfolds. Here, we obtained subsecond estimates of dopamine and serotonin from human substantia nigra pars reticulata during the ultimatum game. Participants, who were patients with Parkinson's disease undergoing awake brain surgery, had to accept or reject monetary offers of varying fairness from human and computer players. They rejected more offers in the human than the computer condition, an effect of social context associated with higher overall levels of dopamine but not serotonin. Regardless of the social context, relative changes in dopamine tracked trial-by-trial changes in offer value-akin to reward prediction errors-whereas serotonin tracked the current offer value. These results show that dopamine and serotonin fluctuations in one of the basal ganglia's main output structures reflect distinct social context and value signals.
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Affiliation(s)
- Seth R Batten
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA.
| | - Dan Bang
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA.
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
- Wellcome Centre for Human Neuroimaging, University College London, London, UK.
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Neuromodulation, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arianna N Davis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew Heflin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Qixiu Fu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ofer Perl
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kimia Ziafat
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alice Hashemi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ignacio Saez
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leonardo S Barbosa
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA
| | - Thomas Twomey
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA
| | - Terry Lohrenz
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA
| | - Jason P White
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA
| | - Peter Dayan
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- University of Tübingen, Tübingen, Germany
| | - Alexander W Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Neuromodulation, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Neuromodulation, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth T Kishida
- Department of Translational Neuroscience, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Xiaosi Gu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - P Read Montague
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA.
- Wellcome Centre for Human Neuroimaging, University College London, London, UK.
- Department of Physics, Virginia Tech, Blacksburg, VA, USA.
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5
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Young JJ, Chan AHW, Jette N, Bender HA, Saad AE, Saez I, Panov F, Ghatan S, Yoo JY, Singh A, Fields MC, Marcuse LV, Mayberg HS. Elevated phase amplitude coupling as a depression biomarker in epilepsy. Epilepsy Behav 2024; 152:109659. [PMID: 38301454 PMCID: PMC10923038 DOI: 10.1016/j.yebeh.2024.109659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/28/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024]
Abstract
Depression is prevalent in epilepsy patients and their intracranial brain activity recordings can be used to determine the types of brain activity that are associated with comorbid depression. We performed case-control comparison of spectral power and phase amplitude coupling (PAC) in 34 invasively monitored drug resistant epilepsy patients' brain recordings. The values of spectral power and PAC for one-minute segments out of every hour in a patient's study were correlated with pre-operative assessment of depressive symptoms by Beck Depression Inventory-II (BDI). We identified an elevated PAC signal (theta-alpha-beta phase (5-25 Hz)/gamma frequency (80-100 Hz) band) that is present in high BDI scores but not low BDI scores adult epilepsy patients in brain regions implicated in primary depression, including anterior cingulate cortex, amygdala and orbitofrontal cortex. Our results showed the application of PAC as a network-specific, electrophysiologic biomarker candidate for comorbid depression and its potential as treatment target for neuromodulation.
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Affiliation(s)
- James J Young
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Andy Ho Wing Chan
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Nathalie Jette
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Heidi A Bender
- Weill Cornell Medicine, Department of Neurological Surgery, 525 East 68th Street, New York, NY 10021, USA
| | - Adam E Saad
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Ignacio Saez
- Departments of Neurocience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Fedor Panov
- Departments of Neurosurgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Saadi Ghatan
- Departments of Neurosurgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Ji Yeoun Yoo
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Anuradha Singh
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Madeline C Fields
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Lara V Marcuse
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Helen S Mayberg
- Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Departments of Neurosurgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
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6
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Johnson KA, Dosenbach NUF, Gordon EM, Welle CG, Wilkins KB, Bronte-Stewart HM, Voon V, Morishita T, Sakai Y, Merner AR, Lázaro-Muñoz G, Williamson T, Horn A, Gilron R, O'Keeffe J, Gittis AH, Neumann WJ, Little S, Provenza NR, Sheth SA, Fasano A, Holt-Becker AB, Raike RS, Moore L, Pathak YJ, Greene D, Marceglia S, Krinke L, Tan H, Bergman H, Pötter-Nerger M, Sun B, Cabrera LY, McIntyre CC, Harel N, Mayberg HS, Krystal AD, Pouratian N, Starr PA, Foote KD, Okun MS, Wong JK. Proceedings of the 11th Annual Deep Brain Stimulation Think Tank: pushing the forefront of neuromodulation with functional network mapping, biomarkers for adaptive DBS, bioethical dilemmas, AI-guided neuromodulation, and translational advancements. Front Hum Neurosci 2024; 18:1320806. [PMID: 38450221 PMCID: PMC10915873 DOI: 10.3389/fnhum.2024.1320806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
The Deep Brain Stimulation (DBS) Think Tank XI was held on August 9-11, 2023 in Gainesville, Florida with the theme of "Pushing the Forefront of Neuromodulation". The keynote speaker was Dr. Nico Dosenbach from Washington University in St. Louis, Missouri. He presented his research recently published in Nature inn a collaboration with Dr. Evan Gordon to identify and characterize the somato-cognitive action network (SCAN), which has redefined the motor homunculus and has led to new hypotheses about the integrative networks underpinning therapeutic DBS. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers, and researchers (from industry and academia) can freely discuss current and emerging DBS technologies, as well as logistical and ethical issues facing the field. The group estimated that globally more than 263,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. This year's meeting was focused on advances in the following areas: cutting-edge translational neuromodulation, cutting-edge physiology, advances in neuromodulation from Europe and Asia, neuroethical dilemmas, artificial intelligence and computational modeling, time scales in DBS for mood disorders, and advances in future neuromodulation devices.
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Affiliation(s)
- Kara A. Johnson
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Nico U. F. Dosenbach
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Evan M. Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Cristin G. Welle
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, United States
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States
| | - Kevin B. Wilkins
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Helen M. Bronte-Stewart
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Takashi Morishita
- Department of Neurosurgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yuki Sakai
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Amanda R. Merner
- Center for Bioethics, Harvard Medical School, Boston, MA, United States
| | - Gabriel Lázaro-Muñoz
- Center for Bioethics, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Theresa Williamson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States
| | - Andreas Horn
- Department of Neurology, Center for Brain Circuit Therapeutics, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, United States
- MGH Neurosurgery and Center for Neurotechnology and Neurorecovery (CNTR) at MGH Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | | | | | - Aryn H. Gittis
- Biological Sciences and Center for Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Simon Little
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Nicole R. Provenza
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network (UHN), University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
| | - Abbey B. Holt-Becker
- Restorative Therapies Group Implantables, Research, and Core Technology, Medtronic Inc., Minneapolis, MN, United States
| | - Robert S. Raike
- Restorative Therapies Group Implantables, Research, and Core Technology, Medtronic Inc., Minneapolis, MN, United States
| | - Lisa Moore
- Boston Scientific Neuromodulation Corporation, Valencia, CA, United States
| | | | - David Greene
- NeuroPace, Inc., Mountain View, CA, United States
| | - Sara Marceglia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Lothar Krinke
- Newronika SPA, Milan, Italy
- Department of Neuroscience, West Virginia University, Morgantown, WV, United States
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Hagai Bergman
- Edmond and Lily Safar Center (ELSC) for Brain Research and Department of Medical Neurobiology (Physiology), Institute of Medical Research Israel-Canada, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Neurosurgery, Hadassah Medical Center, Jerusalem, Israel
| | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Laura Y. Cabrera
- Neuroethics, Department of Engineering Science and Mechanics, Philosophy, and Bioethics, and the Rock Ethics Institute, Pennsylvania State University, State College, PA, United States
| | - Cameron C. McIntyre
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
- Department of Neurosurgery, Duke University, Durham, NC, United States
| | - Noam Harel
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Helen S. Mayberg
- Department of Neurology, Neurosurgery, Psychiatry, and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Andrew D. Krystal
- Departments of Psychiatry and Behavioral Science and Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Nader Pouratian
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Philip A. Starr
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Kelly D. Foote
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Michael S. Okun
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Joshua K. Wong
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
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van Rheede JJ, Alagapan S, Denison TJ, Riva-Posse P, Rozell CJ, Mayberg HS, Waters AC, Sharott A. Cortical signatures of sleep are altered following effective deep brain stimulation for depression. Transl Psychiatry 2024; 14:103. [PMID: 38378677 PMCID: PMC10879134 DOI: 10.1038/s41398-024-02816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Deep brain stimulation (DBS) of the subcallosal cingulate cortex (SCC) is an experimental therapy for treatment-resistant depression (TRD). Chronic SCC DBS leads to long-term changes in the electrophysiological dynamics measured from local field potential (LFP) during wakefulness, but it is unclear how it impacts sleep-related brain activity. This is a crucial gap in knowledge, given the link between depression and sleep disturbances, and an emerging interest in the interaction between DBS, sleep, and circadian rhythms. We therefore sought to characterize changes in electrophysiological markers of sleep associated with DBS treatment for depression. We analyzed key electrophysiological signatures of sleep-slow-wave activity (SWA, 0.5-4.5 Hz) and sleep spindles-in LFPs recorded from the SCC of 9 patients who responded to DBS for TRD. This allowed us to compare the electrophysiological changes before and after 24 weeks of therapeutically effective SCC DBS. SWA power was highly correlated between hemispheres, consistent with a global sleep state. Furthermore, SWA occurred earlier in the night after chronic DBS and had a more prominent peak. While we found no evidence for changes to slow-wave power or stability, we found an increase in the density of sleep spindles. Our results represent a first-of-its-kind report on long-term electrophysiological markers of sleep recorded from the SCC in patients with TRD, and provides evidence of earlier NREM sleep and increased sleep spindle activity following clinically effective DBS treatment. Future work is needed to establish the causal relationship between long-term DBS and the neural mechanisms underlying sleep.
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Affiliation(s)
- Joram J van Rheede
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
| | - Sankaraleengam Alagapan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Timothy J Denison
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Institute for Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher J Rozell
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allison C Waters
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Sharott
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
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8
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Johnson KA, Okun MS, Scangos KW, Mayberg HS, de Hemptinne C. Deep brain stimulation for refractory major depressive disorder: a comprehensive review. Mol Psychiatry 2024:10.1038/s41380-023-02394-4. [PMID: 38287101 DOI: 10.1038/s41380-023-02394-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/31/2024]
Abstract
Deep brain stimulation (DBS) has emerged as a promising treatment for select patients with refractory major depressive disorder (MDD). The clinical effectiveness of DBS for MDD has been demonstrated in meta-analyses, open-label studies, and a few controlled studies. However, randomized controlled trials have yielded mixed outcomes, highlighting challenges that must be addressed prior to widespread adoption of DBS for MDD. These challenges include tracking MDD symptoms objectively to evaluate the clinical effectiveness of DBS with sensitivity and specificity, identifying the patient population that is most likely to benefit from DBS, selecting the optimal patient-specific surgical target and stimulation parameters, and understanding the mechanisms underpinning the therapeutic benefits of DBS in the context of MDD pathophysiology. In this review, we provide an overview of the latest clinical evidence of MDD DBS effectiveness and the recent technological advancements that could transform our understanding of MDD pathophysiology, improve the clinical outcomes for MDD DBS, and establish a path forward to develop more effective neuromodulation therapies to alleviate depressive symptoms.
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Affiliation(s)
- Kara A Johnson
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Katherine W Scangos
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, 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.
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Meyer GM, Hollunder B, Li N, Butenko K, Dembek TA, Hart L, Nombela C, Mosley P, Akram H, Acevedo N, Borron BM, Chou T, Castaño Montoya JP, Strange B, Barcia JA, Tyagi H, Castle DJ, Smith AH, Choi KS, Kopell BH, Mayberg HS, Sheth SA, Goodman W, Leentjens AFG, Richardson RM, Rossell SL, Bosanac P, Cosgrove GR, Kuhn J, Visser-Vandewalle V, Figee M, Dougherty DD, Siddiqi SH, Zrinzo L, Joyce E, Baldermann JC, Fox MD, Neudorfer C, Horn A. Deep Brain Stimulation for Obsessive-Compulsive Disorder: Optimal Stimulation Sites. Biol Psychiatry 2023:S0006-3223(23)01785-7. [PMID: 38141909 DOI: 10.1016/j.biopsych.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Deep brain stimulation (DBS) is a promising treatment option for treatment-refractory obsessive-compulsive disorder (OCD). Several stimulation targets have been used, mostly in and around the anterior limb of the internal capsule and ventral striatum. However, the precise target within this region remains a matter of debate. METHODS Here, we retrospectively studied a multicenter cohort of 82 patients with OCD who underwent DBS of the ventral capsule/ventral striatum and mapped optimal stimulation sites in this region. RESULTS DBS sweet-spot mapping performed on a discovery set of 58 patients revealed 2 optimal stimulation sites associated with improvements on the Yale-Brown Obsessive Compulsive Scale, one in the anterior limb of the internal capsule that overlapped with a previously identified OCD-DBS response tract and one in the region of the inferior thalamic peduncle and bed nucleus of the stria terminalis. Critically, the nucleus accumbens proper and anterior commissure were associated with beneficial but suboptimal clinical improvements. Moreover, overlap with the resulting sweet- and sour-spots significantly estimated variance in outcomes in an independent cohort of 22 patients from 2 additional DBS centers. Finally, beyond obsessive-compulsive symptoms, stimulation of the anterior site was associated with optimal outcomes for both depression and anxiety, while the posterior site was only associated with improvements in depression. CONCLUSIONS Our results suggest how to refine targeting of DBS in OCD and may be helpful in guiding DBS programming in existing patients.
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Affiliation(s)
- Garance M Meyer
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Barbara Hollunder
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany; Einstein Center for Neurosciences Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ningfei Li
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Konstantin Butenko
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Till A Dembek
- Department of Neurology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Lauren Hart
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cristina Nombela
- Biological and Health Psychology, School of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Philip Mosley
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia; Neurosciences Queensland, St. Andrew's War Memorial Hospital, Spring Hill, Queensland, Australia; Queensland Brain Institute, University of Queensland, St. Lucia, Brisbane, Queensland, Australia; Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation Health and Biosecurity, Herston, Queensland, Australia
| | - Harith Akram
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Nicola Acevedo
- Centre for Mental Health, Swinburne University, Melbourne, Victoria, Australia; St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Benjamin M Borron
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tina Chou
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Juan Pablo Castaño Montoya
- Department of Neurosurgery, Hospital Clínico San Carlos, Instituto de Investigacion Sanitaria San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Bryan Strange
- Laboratory for Clinical Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Juan A Barcia
- Department of Neurosurgery, Hospital Clínico San Carlos, Instituto de Investigacion Sanitaria San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Himanshu Tyagi
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - David J Castle
- University of Tasmania and Centre for Mental Health Service Innovation, Tasmania, Australia; State-wide Mental Health Service, Tasmania, Australia
| | - Andrew H Smith
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sameer A Sheth
- Department of Electrical and Computer Engineering, Rice University, Houston, Texas; Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, Texas
| | - Wayne Goodman
- Department of Electrical and Computer Engineering, Rice University, Houston, Texas; Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, Texas
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
| | - R Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University, Melbourne, Victoria, Australia; St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Peter Bosanac
- St. Vincent's Hospital, Melbourne, Victoria, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - G Rees Cosgrove
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Oberhausen, EVKLN, Oberhausen, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shan H Siddiqi
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Eileen Joyce
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Juan Carlos Baldermann
- Department of Neurology, Faculty of Medicine, University of Cologne, Cologne, Germany; Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael D Fox
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Clemens Neudorfer
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andreas Horn
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany; Einstein Center for Neurosciences Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Xu E, Pitts S, Dahill-Fuchel J, Scherrer S, Nauvel T, Overton JG, Riva-Posse P, Crowell A, Figee M, Alagapan S, Rozell C, Choi KS, Mayberg HS, Waters AC. Neural Interoceptive Processing is Modulated by Deep Brain Stimulation for Treatment Resistant Depression. bioRxiv 2023:2023.12.15.571885. [PMID: 38187733 PMCID: PMC10769181 DOI: 10.1101/2023.12.15.571885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background A critical advance in depression research is to clarify the hypothesized role of interoceptive processing in neural mechanisms of treatment efficacy. This study tests whether cortical interoceptive processing, as indexed by the heartbeat-evoked potential (HEP), is modulated by deep brain stimulation (DBS) to the subcallosal cingulate (SCC) for treatment resistant depression (TRD). Methods Eight patients with TRD were enrolled in a study of SCC DBS safety and efficacy. Electroencephalography (EEG) and symptom severity measures were sampled in a laboratory setting over the course of a six-month treatment protocol. The primary outcome measure was an EEG-derived HEP, which reflects cortical processing of heartbeat sensation. Cluster-based permutation analyses were used to test the effect of stimulation and time in treatment on the HEP. The change in signal magnitude after treatment was correlated with change in depression severity as measured by the 17-item Hamilton Depression Rating Scale. Results HEP amplitude was greater after 24 weeks of treatment ( t (7)=-4.40, p =.003, g= -1.38, 95% Cl [-2.3, -0.42]), and this change was inversely correlated with latency of treatment response (rho = -0.75, 95% Cl [-0.95, -0.11], p= .03). An acute effect of DBS was also observed, but as a decrease in HEP amplitude ( t (6) =6.66, p <.001, g= 2.19, 95% Cl [0.81, 3.54]). HEP differences were most pronounced over left posterior sensors from 405-425 ms post-stimulus. Conclusion Brain-based evidence substantiates a theorized link between interoception and depression, and suggests an interoceptive contribution to the mechanism of treatment efficacy with deep brain stimulation for severe depression.
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Dunlop BW, Cha J, Choi KS, Nemeroff CB, Craighead WE, Mayberg HS. Functional connectivity of salience and affective networks among remitted depressed patients predicts episode recurrence. Neuropsychopharmacology 2023; 48:1901-1909. [PMID: 37491672 PMCID: PMC10584833 DOI: 10.1038/s41386-023-01653-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/09/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023]
Abstract
Recurrent episodes in major depressive disorder (MDD) are common but the neuroimaging features predictive of recurrence are not established. Participants in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study who achieved remission after 12 weeks of treatment withcognitive behavior therapy, duloxetine, or escitalopram were prospectively monitored for up to 21 months for recurrence. Neuroimaging markers predictive of recurrence were identified from week 12 functional magnetic resonance imaging scans by analyzing whole-brain resting state functional connectivity (RSFC) using seeds for four brain networks that are altered in MDD. Neuroimaging correlates of established clinical predictors of recurrence, including the magnitude of depressive (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale) symptom severity at time of remission, and a comorbid anxiety disorder were examined for their similarity to the neuroimaging predictors of recurrence. Of the 344 patients randomized in PReDICT, 61 achieved remission and had usable scans for analysis, 9 of whom experienced recurrence during follow-up. Recurrence was predicted by: 1) increased RSFC between subcallosal cingulate cortex (SCC) and right anterior insula, 2) decreased RSFC between SCC and bilateral primary visual cortex, and 3) decreased RSFC between insula and bilateral caudate. Week 12 depression and anxiety scores were negatively correlated with RSFC strength between executive control and default mode networks, but they were not correlated with the three RSFC patterns predicting recurrence. We conclude that altered RSFC in SCC and anterior insula networks are prospective risk factors associated with MDD recurrence, reflecting additional sources of risk beyond clinical measures.
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Affiliation(s)
- Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA.
| | - Jungho Cha
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ki Sueng Choi
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin, USA
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA
- Department of Psychology, Emory University, Atlanta, USA
| | - Helen S Mayberg
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
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12
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Cha J, Choi KS, Rajendra JK, McGrath CL, Riva-Posse P, Holtzheimer PE, Figee M, Kopell BH, Mayberg HS. Whole brain network effects of subcallosal cingulate deep brain stimulation for treatment-resistant depression. Mol Psychiatry 2023:10.1038/s41380-023-02306-6. [PMID: 37919403 DOI: 10.1038/s41380-023-02306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023]
Abstract
Ongoing experimental studies of subcallosal cingulate deep brain stimulation (SCC DBS) for treatment-resistant depression (TRD) show a differential timeline of behavioral effects with rapid changes after initial stimulation, and both early and delayed changes over the course of ongoing chronic stimulation. This study examined the longitudinal resting-state regional cerebral blood flow (rCBF) changes in intrinsic connectivity networks (ICNs) with SCC DBS for TRD over 6 months and repeated the same analysis by glucose metabolite changes in a new cohort. A total of twenty-two patients with TRD, 17 [15 O]-water and 5 [18 F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) patients, received SCC DBS and were followed weekly for 7 months. PET scans were collected at 4-time points: baseline, 1-month after surgery, and 1 and 6 months of chronic stimulation. A linear mixed model was conducted to examine the differential trajectory of rCBF changes over time. Post-hoc tests were also examined to assess postoperative, early, and late ICN changes and response-specific effects. SCC DBS had significant time-specific effects in the salience network (SN) and the default mode network (DMN). The rCBF in SN and DMN was decreased after surgery, but responder and non-responders diverged thereafter, with a net increase in DMN activity in responders with chronic stimulation. Additionally, the rCBF in the DMN uniquely correlated with depression severity. The glucose metabolic changes in a second cohort show the same DMN changes. The trajectory of PET changes with SCC DBS is not linear, consistent with the chronology of therapeutic effects. These data provide novel evidence of both an acute reset and ongoing plastic effects in the DMN that may provide future biomarkers to track clinical improvement with ongoing treatment.
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Affiliation(s)
- Jungho Cha
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Justin K Rajendra
- Scientific and Statistical Computational Core, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | | | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Paul E Holtzheimer
- Department of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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DiRisio AC, Avecillas-Chasin JM, Platt S, Jimenez-Shahed J, Figee M, Mayberg HS, Choi KS, Kopell BH. White matter connectivity of subthalamic nucleus and globus pallidus interna targets for deep brain stimulation. J Neurosurg 2023; 139:1366-1375. [PMID: 37119111 DOI: 10.3171/2023.2.jns222576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/23/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus interna (GPi) have differential therapeutic effects for Parkinson's disease (PD) that drive patient selection. For example, GPi DBS is preferred for dystonic features and dyskinesia, whereas STN DBS has shown faster tremor control and medication reduction. Connectivity studies comparing these two targets, using patient-specific data, are still lacking. The objective was to find STN and GPi structural connectivity patterns in order to better understand differences in DBS-activated brain circuits between these two stimulation targets and to guide optimal contact selection. METHODS The authors simulated DBS activation along the main axis of both the STN and GPi by using volume of activated tissue (VAT) modeling with known average stimulation parameters (2.8 V and 60 μsec for STN; 3.3 V and 90 μsec for GPi). The authors modeled VATs in the anterior, middle, and posterior STN and the anterior, midanterior, midposterior, and posterior GPi. The authors generated maps of the connections shared by the patients for each VAT by using probabilistic tractography of diffusion-weighted imaging data obtained in 46 PD patients who underwent DBS (26 with STN and 20 with GPi targeting), and differences between VATs for whole-brain and distal regions of interest (prefrontal cortex, supplementary motor area, primary motor cortex, primary sensory cortex, caudate, motor thalamus, and cerebellum) were generated from structural atlases. Differences between maps were quantified and compared. RESULTS VATs across the STN and GPi had different structural connectivity patterns. The authors found significant connectivity differences between VATs for all regions of interest. Posterior and middle STN showed stronger connectivity to the primary motor cortex and supplementary motor area (SMA) (p < 0.001). Posterior STN had the strongest connectivity to the primary sensory cortex and motor thalamus (p < 0.001). Posterior GPi showed stronger connectivity to the primary motor cortex (p < 0.001). Connectivity to the SMA was similar for the posterior and midposterior GPi (p > 0.05), which was greater than that for the anterior GPi (p < 0.001). When both nuclei were compared, posterior and middle STN had stronger connectivity to the SMA, cerebellum, and motor thalamus than GPi (all p < 0.001). Posterior GPi and STN had similar connectivity to the primary sensory cortex. CONCLUSIONS On patient-specific imaging, structural connectivity differences existed between GPi and STN DBS, as measured with standardized electrical field modeling of the DBS targets. These connectivity differences may correlate with the differential clinical benefits obtained by targeting each of the two nuclei with DBS for PD. Prospective work is needed to relate these differences to clinical outcomes and to inform targeting and programming.
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Affiliation(s)
- Aislyn C DiRisio
- 1Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
- 3Department of Neurosurgery, University of California, Los Angeles, California
| | - Josue M Avecillas-Chasin
- 1Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
- 2Department of Neurosurgery, Center for Neuromodulation, Icahn School of Medicine at Mount Sinai, New York, New York
- 4Department of Neurosurgery, University of Nebraska Medical Center, Omaha, Nebraska
| | - Samantha Platt
- 5Department of Radiology, New York University, New York, New York; and
| | - Joohi Jimenez-Shahed
- 1Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
- Departments of6Neurology
| | - Martijn Figee
- 1Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
- 7Psychiatry, and
| | - Helen S Mayberg
- 1Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
- 2Department of Neurosurgery, Center for Neuromodulation, Icahn School of Medicine at Mount Sinai, New York, New York
- Departments of6Neurology
- 7Psychiatry, and
| | - Ki Sueng Choi
- 1Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
- 8Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brian H Kopell
- 1Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
- 2Department of Neurosurgery, Center for Neuromodulation, Icahn School of Medicine at Mount Sinai, New York, New York
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Alagapan S, Choi KS, Heisig S, Riva-Posse P, Crowell A, Tiruvadi V, Obatusin M, Veerakumar A, Waters AC, Gross RE, Quinn S, Denison L, O'Shaughnessy M, Connor M, Canal G, Cha J, Hershenberg R, Nauvel T, Isbaine F, Afzal MF, Figee M, Kopell BH, Butera R, Mayberg HS, Rozell CJ. Cingulate dynamics track depression recovery with deep brain stimulation. Nature 2023; 622:130-138. [PMID: 37730990 PMCID: PMC10550829 DOI: 10.1038/s41586-023-06541-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 08/09/2023] [Indexed: 09/22/2023]
Abstract
Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) can provide long-term symptom relief for treatment-resistant depression (TRD)1. However, achieving stable recovery is unpredictable2, typically requiring trial-and-error stimulation adjustments due to individual recovery trajectories and subjective symptom reporting3. We currently lack objective brain-based biomarkers to guide clinical decisions by distinguishing natural transient mood fluctuations from situations requiring intervention. To address this gap, we used a new device enabling electrophysiology recording to deliver SCC DBS to ten TRD participants (ClinicalTrials.gov identifier NCT01984710). At the study endpoint of 24 weeks, 90% of participants demonstrated robust clinical response, and 70% achieved remission. Using SCC local field potentials available from six participants, we deployed an explainable artificial intelligence approach to identify SCC local field potential changes indicating the patient's current clinical state. This biomarker is distinct from transient stimulation effects, sensitive to therapeutic adjustments and accurate at capturing individual recovery states. Variable recovery trajectories are predicted by the degree of preoperative damage to the structural integrity and functional connectivity within the targeted white matter treatment network, and are matched by objective facial expression changes detected using data-driven video analysis. Our results demonstrate the utility of objective biomarkers in the management of personalized SCC DBS and provide new insight into the relationship between multifaceted (functional, anatomical and behavioural) features of TRD pathology, motivating further research into causes of variability in depression treatment.
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Affiliation(s)
- Sankaraleengam Alagapan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen Heisig
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrea Crowell
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Vineet Tiruvadi
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | - Mosadoluwa Obatusin
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashan Veerakumar
- Department of Psychiatry, Schulich School of Medicine and Dentistry at Western University, London, Ontario, Canada
| | - Allison C Waters
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert E Gross
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Sinead Quinn
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Lydia Denison
- Emory University School of Medicine, Atlanta, GA, USA
| | - Matthew O'Shaughnessy
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Marissa Connor
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Gregory Canal
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jungho Cha
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Hershenberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Tanya Nauvel
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Faical Isbaine
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Muhammad Furqan Afzal
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Butera
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Christopher J Rozell
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
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15
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Elias GJB, Germann J, Boutet A, Beyn ME, Giacobbe P, Song HN, Choi KS, Mayberg HS, Kennedy SH, Lozano AM. Local neuroanatomical and tract-based proxies of optimal subcallosal cingulate deep brain stimulation. Brain Stimul 2023; 16:1259-1272. [PMID: 37611657 DOI: 10.1016/j.brs.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/02/2023] [Accepted: 08/19/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Deep brain stimulation of the subcallosal cingulate area (SCC-DBS) is a promising neuromodulatory therapy for treatment-resistant depression (TRD). Biomarkers of optimal target engagement are needed to guide surgical targeting and stimulation parameter selection and to reduce variance in clinical outcome. OBJECTIVE/HYPOTHESIS We aimed to characterize the relationship between stimulation location, white matter tract engagement, and clinical outcome in a large (n = 60) TRD cohort treated with SCC-DBS. A smaller cohort (n = 22) of SCC-DBS patients with differing primary indications (bipolar disorder/anorexia nervosa) was utilized as an out-of-sample validation cohort. METHODS Volumes of tissue activated (VTAs) were constructed in standard space using high-resolution structural MRI and individual stimulation parameters. VTA-based probabilistic stimulation maps (PSMs) were generated to elucidate voxelwise spatial patterns of efficacious stimulation. A whole-brain tractogram derived from Human Connectome Project diffusion-weighted MRI data was seeded with VTA pairs, and white matter streamlines whose overlap with VTAs related to outcome ('discriminative' streamlines; Puncorrected < 0.05) were identified using t-tests. Linear modelling was used to interrogate the potential clinical relevance of VTA overlap with specific structures. RESULTS PSMs varied by hemisphere: high-value left-sided voxels were located more anterosuperiorly and squarely in the lateral white matter, while the equivalent right-sided voxels fell more posteroinferiorly and involved a greater proportion of grey matter. Positive discriminative streamlines localized to the bilateral (but primarily left) cingulum bundle, forceps minor/rostrum of corpus callosum, and bilateral uncinate fasciculus. Conversely, negative discriminative streamlines mostly belonged to the right cingulum bundle and bilateral uncinate fasciculus. The best performing linear model, which utilized information about VTA volume overlap with each of the positive discriminative streamline bundles as well as the negative discriminative elements of the right cingulum bundle, explained significant variance in clinical improvement in the primary TRD cohort (R = 0.46, P < 0.001) and survived repeated 10-fold cross-validation (R = 0.50, P = 0.040). This model was also able to predict outcome in the out-of-sample validation cohort (R = 0.43, P = 0.047). CONCLUSION(S) These findings reinforce prior indications of the importance of white matter engagement to SCC-DBS treatment success while providing new insights that could inform surgical targeting and stimulation parameter selection decisions.
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Affiliation(s)
- Gavin J B Elias
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada; Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada
| | - Jürgen Germann
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada; Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada
| | - Alexandre Boutet
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada; Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada; Joint Department of Medical Imaging, University of Toronto, Toronto, M5T 1W7, Canada
| | - Michelle E Beyn
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Peter Giacobbe
- Department of Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, M4N 3M5, Canada
| | - Ha Neul Song
- Nash Family Center for Advanced Circuit Therapeutics, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA; Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sidney H Kennedy
- Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada; ASR Suicide and Depression Studies Unit, St. Michael's Hospital, University of Toronto, M5B 1M8, Canada; Department of Psychiatry, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada; Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada.
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16
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Ryu J, Heisig S, McLaughlin C, Katz M, Mayberg HS, Gu X. A natural language processing approach reveals first-person pronoun usage and non-fluency as markers of therapeutic alliance in psychotherapy. iScience 2023; 26:106860. [PMID: 37255661 PMCID: PMC10225921 DOI: 10.1016/j.isci.2023.106860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/18/2023] [Accepted: 05/08/2023] [Indexed: 06/01/2023] Open
Abstract
It remains elusive what language markers derived from psychotherapy sessions are indicative of therapeutic alliance, limiting our capacity to assess and provide feedback on the trusting quality of the patient-clinician relationship. To address this critical knowledge gap, we leveraged feature extraction methods from natural language processing (NLP), a subfield of artificial intelligence, to quantify pronoun and non-fluency language markers that are relevant for communicative and emotional aspects of therapeutic relationships. From twenty-eight transcripts of non-manualized psychotherapy sessions recorded in outpatient clinics, we identified therapists' first-person pronoun usage frequency and patients' speech transition marking relaxed interaction style as potential metrics of alliance. Behavioral data from patients who played an economic game that measures social exchange (i.e. trust game) suggested that therapists' first-person pronoun usage may influence alliance ratings through their diminished trusting behavior toward therapists. Together, this work supports that communicative language features in patient-therapist dialogues could be markers of alliance.
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Affiliation(s)
- Jihan Ryu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen Heisig
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caroline McLaughlin
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Katz
- Clinical Psychology Doctoral Program, School of Health Professions and Nursing, Long Island University - CW Post Campus, Greenvale, NY, USA
| | - Helen S. Mayberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaosi Gu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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17
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Mayberg HS, Dunlop BW. Balancing the beautiful and the good in pursuit of biomarkers for depression. World Psychiatry 2023; 22:265-267. [PMID: 37159353 PMCID: PMC10168145 DOI: 10.1002/wps.21081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 05/11/2023] Open
Affiliation(s)
- Helen S Mayberg
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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18
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Paul ER, Östman L, Heilig M, Mayberg HS, Hamilton JP. Towards a multilevel model of major depression: genes, immuno-metabolic function, and cortico-striatal signaling. Transl Psychiatry 2023; 13:171. [PMID: 37208333 DOI: 10.1038/s41398-023-02466-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 05/21/2023] Open
Abstract
Biological assay and imaging techniques have made visible a great deal of the machinery of mental illness. Over fifty years of investigation of mood disorders using these technologies has identified several biological regularities in these disorders. Here we present a narrative connecting genetic, cytokine, neurotransmitter, and neural-systems-level findings in major depressive disorder (MDD). Specifically, we connect recent genome-wide findings in MDD to metabolic and immunological disturbance in this disorder and then detail links between immunological abnormalities and dopaminergic signaling within cortico-striatal circuitry. Following this, we discuss implications of reduced dopaminergic tone for cortico-striatal signal conduction in MDD. Finally, we specify some of the flaws in the current model and propose ways forward for advancing multilevel formulations of MDD most efficiently.
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Affiliation(s)
- Elisabeth R Paul
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Medical Imaging and Visualization, Linköping University, Linköping, Sweden
| | - Lars Östman
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Psychiatry, Region Östergötland, Linköping, Sweden
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Psychiatry, Region Östergötland, Linköping, Sweden
| | | | - J Paul Hamilton
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
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19
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Abstract
The field of stereotactic neurosurgery developed more than 70 years ago to address a therapy gap for patients with severe psychiatric disorders. In the decades since, it has matured tremendously, benefiting from advances in clinical and basic sciences. Deep brain stimulation (DBS) for severe, treatment-resistant psychiatric disorders is currently poised to transition from a stage of empiricism to one increasingly rooted in scientific discovery. Current drivers of this transition are advances in neuroimaging, but rapidly emerging ones are neurophysiological-as we understand more about the neural basis of these disorders, we will more successfully be able to use interventions such as invasive stimulation to restore dysfunctional circuits to health. Paralleling this transition is a steady increase in the consistency and quality of outcome data. Here, we focus on obsessive-compulsive disorder and depression, two topics that have received the most attention in terms of trial volume and scientific effort. Expected final online publication date for the Annual Review of Neuroscience, Volume 46 is July 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Sameer A Sheth
- Departments of Neurosurgery, Psychiatry and Behavioral Sciences, and Neuroscience, Baylor College of Medicine, Houston, Texas, USA;
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry, and Neuroscience, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
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20
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Dunlop BW, Cha J, Choi KS, Rajendra JK, Nemeroff CB, Craighead WE, Mayberg HS. Shared and Unique Changes in Brain Connectivity Among Depressed Patients After Remission With Pharmacotherapy Versus Psychotherapy. Am J Psychiatry 2023; 180:218-229. [PMID: 36651624 DOI: 10.1176/appi.ajp.21070727] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The authors sought to determine the shared and unique changes in brain resting-state functional connectivity (rsFC) between patients with major depressive disorder who achieved remission with cognitive-behavioral therapy (CBT) or with antidepressant medication. METHODS The Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) trial randomized adults with treatment-naive major depressive disorder to 12 weeks of treatment with CBT (16 1-hour sessions) or medication (duloxetine 30-60 mg/day or escitalopram 10-20 mg/day). Resting-state functional MRI scans were performed at baseline and at week 12. The primary outcome was change in the whole-brain rsFC of four seeded brain networks among participants who achieved remission. RESULTS Of the 131 completers with usable MRI data (74 female; mean age, 39.8 years), remission was achieved by 19 of 40 CBT-treated and 45 of 91 medication-treated patients. Three patterns of connectivity changes were observed. First, those who remitted with either treatment shared a pattern of reduction in rsFC between the subcallosal cingulate cortex and the motor cortex. Second, reciprocal rsFC changes were observed across multiple networks, primarily increases in CBT remitters and decreases in medication remitters. And third, in CBT remitters only, rsFC increased within the executive control network and between the executive control network and parietal attention regions. CONCLUSIONS Remission from major depression via treatment with CBT or medication is associated with changes in rsFC that are mostly specific to the treatment modality, providing biological support for the clinical practice of switching between or combining these treatment approaches. Medication is associated with broadly inhibitory effects. In CBT remitters, the increase in rsFC strength between networks involved in cognitive control and attention provides biological support for the theorized mechanism of CBT. Reducing affective network connectivity with motor systems is a shared process important for remission with both CBT and medication.
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Affiliation(s)
- Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Dunlop, Craighead); Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (Cha, Choi, Mayberg); Scientific and Statistical Computational Core, NIMH, Bethesda (Rajendra); Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin (Nemeroff); Department of Psychology, Emory University, Atlanta (Craighead)
| | - Jungho Cha
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Dunlop, Craighead); Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (Cha, Choi, Mayberg); Scientific and Statistical Computational Core, NIMH, Bethesda (Rajendra); Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin (Nemeroff); Department of Psychology, Emory University, Atlanta (Craighead)
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Dunlop, Craighead); Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (Cha, Choi, Mayberg); Scientific and Statistical Computational Core, NIMH, Bethesda (Rajendra); Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin (Nemeroff); Department of Psychology, Emory University, Atlanta (Craighead)
| | - Justin K Rajendra
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Dunlop, Craighead); Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (Cha, Choi, Mayberg); Scientific and Statistical Computational Core, NIMH, Bethesda (Rajendra); Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin (Nemeroff); Department of Psychology, Emory University, Atlanta (Craighead)
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Dunlop, Craighead); Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (Cha, Choi, Mayberg); Scientific and Statistical Computational Core, NIMH, Bethesda (Rajendra); Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin (Nemeroff); Department of Psychology, Emory University, Atlanta (Craighead)
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Dunlop, Craighead); Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (Cha, Choi, Mayberg); Scientific and Statistical Computational Core, NIMH, Bethesda (Rajendra); Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin (Nemeroff); Department of Psychology, Emory University, Atlanta (Craighead)
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Dunlop, Craighead); Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (Cha, Choi, Mayberg); Scientific and Statistical Computational Core, NIMH, Bethesda (Rajendra); Department of Psychiatry and Behavioral Sciences, Institute for Early Life Adversity Research, University of Texas at Austin Dell Medical School, Austin (Nemeroff); Department of Psychology, Emory University, Atlanta (Craighead)
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21
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Tiruvadi V, James S, Howell B, Obatusin M, Crowell A, Riva-Posse P, Gross RE, McIntyre CC, Mayberg HS, Butera R. Mitigating Mismatch Compression in Differential Local Field Potentials. IEEE Trans Neural Syst Rehabil Eng 2023; 31:68-77. [PMID: 36288215 PMCID: PMC10784110 DOI: 10.1109/tnsre.2022.3217469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Deep brain stimulation (DBS) devices capable of measuring differential local field potentials ( ∂ LFP) enable neural recordings alongside clinical therapy. Efforts to identify oscillatory correlates of various brain disorders, or disease readouts, are growing but must proceed carefully to ensure readouts are not distorted by brain environment. In this report we identified, characterized, and mitigated a major source of distortion in ∂ LFP that we introduce as mismatch compression (MC). Using in vivo, in silico, and in vitro models of MC, we showed that impedance mismatches in the two recording electrodes can yield incomplete rejection of stimulation artifact and subsequent gain compression that distorts oscillatory power. We then developed and validated an opensource mitigation pipeline that mitigates the distortions arising from MC. This work enables more reliable oscillatory readouts for adaptive DBS applications.
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22
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Wong JK, Mayberg HS, Wang DD, Richardson RM, Halpern CH, Krinke L, Arlotti M, Rossi L, Priori A, Marceglia S, Gilron R, Cavanagh JF, Judy JW, Miocinovic S, Devergnas AD, Sillitoe RV, Cernera S, Oehrn CR, Gunduz A, Goodman WK, Petersen EA, Bronte-Stewart H, Raike RS, Malekmohammadi M, Greene D, Heiden P, Tan H, Volkmann J, Voon V, Li L, Sah P, Coyne T, Silburn PA, Kubu CS, Wexler A, Chandler J, Provenza NR, Heilbronner SR, Luciano MS, Rozell CJ, Fox MD, de Hemptinne C, Henderson JM, Sheth SA, Okun MS. Proceedings of the 10th annual deep brain stimulation think tank: Advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, interventional psychiatry, and women in neuromodulation. Front Hum Neurosci 2023; 16:1084782. [PMID: 36819295 PMCID: PMC9933515 DOI: 10.3389/fnhum.2022.1084782] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/12/2022] [Indexed: 02/05/2023] Open
Abstract
The deep brain stimulation (DBS) Think Tank X was held on August 17-19, 2022 in Orlando FL. The session organizers and moderators were all women with the theme women in neuromodulation. Dr. Helen Mayberg from Mt. Sinai, NY was the keynote speaker. She discussed milestones and her experiences in developing depression DBS. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers (from industry and academia) can freely discuss current and emerging DBS technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank X speakers was that DBS has continued to expand in scope however several indications have reached the "trough of disillusionment." DBS for depression was considered as "re-emerging" and approaching a slope of enlightenment. DBS for depression will soon re-enter clinical trials. The group estimated that globally more than 244,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. This year's meeting was focused on advances in the following areas: neuromodulation in Europe, Asia, and Australia; cutting-edge technologies, closed loop DBS, DBS tele-health, neuroethics, lesion therapy, interventional psychiatry, and adaptive DBS.
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Affiliation(s)
- Joshua K. Wong
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Helen S. Mayberg
- Department of Neurology, Neurosurgery, Psychiatry, and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Doris D. Wang
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - R. Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Casey H. Halpern
- Richards Medical Research Laboratories, Department of Neurosurgery, Perelman School of Medicine, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA, United States
| | - Lothar Krinke
- Newronika, Goose Creek, SC, United States
- Department of Neuroscience, West Virginia University, Morgantown, WV, United States
| | | | | | | | | | | | - James F. Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Jack W. Judy
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, United States
| | - Svjetlana Miocinovic
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, United States
| | - Annaelle D. Devergnas
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, United States
| | - Roy V. Sillitoe
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Stephanie Cernera
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Carina R. Oehrn
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Aysegul Gunduz
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Wayne K. Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Erika A. Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Helen Bronte-Stewart
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Robert S. Raike
- Restorative Therapies Group Implantables, Research, and Core Technology, Medtronic Inc., Minneapolis, MN, United States
| | | | - David Greene
- NeuroPace, Inc., Mountain View, CA, United States
| | - Petra Heiden
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Jens Volkmann
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Luming Li
- National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
| | - Pankaj Sah
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Terry Coyne
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Peter A. Silburn
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Cynthia S. Kubu
- Department of Neurology, Cleveland Clinic, Cleveland, OH, United States
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, United States
| | - Jennifer Chandler
- Centre for Health Law, Policy, and Ethics, Faculty of Law, University of Ottawa, Ottawa, ON, Canada
| | - Nicole R. Provenza
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Sarah R. Heilbronner
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | - Marta San Luciano
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Christopher J. Rozell
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Michael D. Fox
- Center for Brain Circuit Therapeutics, Department of Neurology, Psychiatry, Radiology, and Neurosurgery, Brigham and Women’s Hospital, Boston, MA, United States
| | - Coralie de Hemptinne
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Jaimie M. Henderson
- Department of Neurosurgery, Stanford University, Stanford, CA, United States
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Michael S. Okun
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
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23
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Fu CHY, Erus G, Fan Y, Antoniades M, Arnone D, Arnott SR, Chen T, Choi KS, Fatt CC, Frey BN, Frokjaer VG, Ganz M, Garcia J, Godlewska BR, Hassel S, Ho K, McIntosh AM, Qin K, Rotzinger S, Sacchet MD, Savitz J, Shou H, Singh A, Stolicyn A, Strigo I, Strother SC, Tosun D, Victor TA, Wei D, Wise T, Woodham RD, Zahn R, Anderson IM, Deakin JFW, Dunlop BW, Elliott R, Gong Q, Gotlib IH, Harmer CJ, Kennedy SH, Knudsen GM, Mayberg HS, Paulus MP, Qiu J, Trivedi MH, Whalley HC, Yan CG, Young AH, Davatzikos C. AI-based dimensional neuroimaging system for characterizing heterogeneity in brain structure and function in major depressive disorder: COORDINATE-MDD consortium design and rationale. BMC Psychiatry 2023; 23:59. [PMID: 36690972 PMCID: PMC9869598 DOI: 10.1186/s12888-022-04509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Efforts to develop neuroimaging-based biomarkers in major depressive disorder (MDD), at the individual level, have been limited to date. As diagnostic criteria are currently symptom-based, MDD is conceptualized as a disorder rather than a disease with a known etiology; further, neural measures are often confounded by medication status and heterogeneous symptom states. METHODS We describe a consortium to quantify neuroanatomical and neurofunctional heterogeneity via the dimensions of novel multivariate coordinate system (COORDINATE-MDD). Utilizing imaging harmonization and machine learning methods in a large cohort of medication-free, deeply phenotyped MDD participants, patterns of brain alteration are defined in replicable and neurobiologically-based dimensions and offer the potential to predict treatment response at the individual level. International datasets are being shared from multi-ethnic community populations, first episode and recurrent MDD, which are medication-free, in a current depressive episode with prospective longitudinal treatment outcomes and in remission. Neuroimaging data consist of de-identified, individual, structural MRI and resting-state functional MRI with additional positron emission tomography (PET) data at specific sites. State-of-the-art analytic methods include automated image processing for extraction of anatomical and functional imaging variables, statistical harmonization of imaging variables to account for site and scanner variations, and semi-supervised machine learning methods that identify dominant patterns associated with MDD from neural structure and function in healthy participants. RESULTS We are applying an iterative process by defining the neural dimensions that characterise deeply phenotyped samples and then testing the dimensions in novel samples to assess specificity and reliability. Crucially, we aim to use machine learning methods to identify novel predictors of treatment response based on prospective longitudinal treatment outcome data, and we can externally validate the dimensions in fully independent sites. CONCLUSION We describe the consortium, imaging protocols and analytics using preliminary results. Our findings thus far demonstrate how datasets across many sites can be harmonized and constructively pooled to enable execution of this large-scale project.
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Affiliation(s)
- Cynthia H Y Fu
- Department of Psychological Sciences, University of East London, London, UK.
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Mathilde Antoniades
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Danilo Arnone
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Taolin Chen
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Cherise Chin Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Mood Disorders Treatment and Research Centre and Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Vibe G Frokjaer
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Jose Garcia
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Beata R Godlewska
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Stefanie Hassel
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Keith Ho
- Department of Psychiatry, University Health Network, Toronto, Canada
| | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Kun Qin
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Susan Rotzinger
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | | | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE) Center, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, USA
| | - Ashish Singh
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Aleks Stolicyn
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Irina Strigo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Centre, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | | | - Dongtao Wei
- School of Psychology, Southwest University, Chongqing, China
| | - Toby Wise
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rachel D Woodham
- Department of Psychological Sciences, University of East London, London, UK
| | - Roland Zahn
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Ian M Anderson
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - J F William Deakin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA
| | - Rebecca Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, USA
| | | | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
- Unity Health Toronto, Toronto, Canada
| | - Gitte M Knudsen
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Jiang Qiu
- School of Psychology, Southwest University, Chongqing, China
| | - Madhukar H Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Heather C Whalley
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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24
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Okun MS, Mayberg HS, DeLong MR. Muhammad Ali and Young-Onset Idiopathic Parkinson Disease-The Missing Evidence. JAMA Neurol 2023; 80:5-6. [PMID: 36279117 DOI: 10.1001/jamaneurol.2022.3584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This Viewpoint discusses the degree to which Parkinson disease vs repetitive boxing-related head trauma contributed to Muhammad Ali’s progressive motor and cognitive impairments.
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Affiliation(s)
- Michael S Okun
- Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, Gainesville.,Associate Editor, JAMA Neurology
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry, and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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25
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Gray JP, Manuello J, Alexander-Bloch AF, Leonardo C, Franklin C, Choi KS, Cauda F, Costa T, Blangero J, Glahn DC, Mayberg HS, Fox PT. Co-alteration Network Architecture of Major Depressive Disorder: A Multi-modal Neuroimaging Assessment of Large-scale Disease Effects. Neuroinformatics 2022; 21:443-455. [PMID: 36469193 DOI: 10.1007/s12021-022-09614-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 12/12/2022]
Abstract
Major depressive disorder (MDD) exhibits diverse symptomology and neuroimaging studies report widespread disruption of key brain areas. Numerous theories underpinning the network degeneration hypothesis (NDH) posit that neuropsychiatric diseases selectively target brain areas via meaningful network mechanisms rather than as indistinct disease effects. The present study tests the hypothesis that MDD is a network-based disorder, both structurally and functionally. Coordinate-based meta-analysis and Activation Likelihood Estimation (CBMA-ALE) were used to assess the convergence of findings from 92 previously published studies in depression. An extension of CBMA-ALE was then used to generate a node-and-edge network model representing the co-alteration of brain areas impacted by MDD. Standardized measures of graph theoretical network architecture were assessed. Co-alteration patterns among the meta-analytic MDD nodes were then tested in independent, clinical T1-weighted structural magnetic resonance imaging (MRI) and resting-state functional (rs-fMRI) data. Differences in co-alteration profiles between MDD patients and healthy controls, as well as between controls and clinical subgroups of MDD patients, were assessed. A 65-node 144-edge co-alteration network model was derived for MDD. Testing of co-alteration profiles in replication data using the MDD nodes provided distinction between MDD and healthy controls in structural data. However, co-alteration profiles were not distinguished between patients and controls in rs-fMRI data. Improved distinction between patients and healthy controls was observed in clinically homogenous MDD subgroups in T1 data. MDD abnormalities demonstrated both structural and functional network architecture, though only structural networks exhibited between-groups differences. Our findings suggest improved utility of structural co-alteration networks for ongoing biomarker development.
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26
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Kennedy JC, Dunlop BW, Craighead LW, Nemeroff CB, Mayberg HS, Craighead WE. Assessing in-session rumination and its effects on CBT for depression. Behav Res Ther 2022; 159:104209. [PMID: 36283238 DOI: 10.1016/j.brat.2022.104209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/29/2022] [Accepted: 10/05/2022] [Indexed: 12/14/2022]
Abstract
The study evaluated if rumination of patients during therapy (i.e., in-session rumination) relates to whether or not they do less well in CBT treatment. We developed a reliably assessed in-session rumination observational measure and evaluated its relationship to depression over the course of CBT. Rated sessions came from 63 treatment-naïve patients with major depressive disorder who participated in CBT in the PReDICT study (Dunlop et al., 2017). In-session rumination was operationalized as repetitive, negative, and passive talking about depressive topics. Trained undergraduates rated the intensity and duration of in-session rumination occurring during 57 initial therapy sessions (i.e., session one) and 45 sessions in the middle of treatment (i.e., session eight). The observational ratings were sufficiently reliable (all ICCs > 0.69). Mixed model results indicated that greater intensity of in-session rumination during the initial treatment session predicted higher levels of subsequent clinician-rated depressive symptoms (p < .023). Regression results indicated that greater intensity and duration of in-session rumination at session 8 significantly predicted higher clinician-rated symptoms at end of treatment (p's < 0.02). In-session rumination intensity and duration were not, however, related to subsequent self-reported depressive symptoms. The results support efforts to identify which patients might benefit from rumination-specific interventions.
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Affiliation(s)
- J C Kennedy
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States; Department of Psychology, Emory University, Atlanta, GA, United States
| | - B W Dunlop
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - L W Craighead
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - C B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Dell School of Medicine, University of Texas, Austin, TX, United States
| | - H S Mayberg
- The Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - W E Craighead
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States; Department of Psychology, Emory University, Atlanta, GA, United States.
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27
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Smith EE, Choi KS, Veerakumar A, Obatusin M, Howell B, Smith AH, Tiruvadi V, Crowell AL, Riva-Posse P, Alagapan S, Rozell CJ, Mayberg HS, Waters AC. Time-frequency signatures evoked by single-pulse deep brain stimulation to the subcallosal cingulate. Front Hum Neurosci 2022; 16:939258. [PMID: 36061500 PMCID: PMC9433578 DOI: 10.3389/fnhum.2022.939258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Precision targeting of specific white matter bundles that traverse the subcallosal cingulate (SCC) has been linked to efficacy of deep brain stimulation (DBS) for treatment resistant depression (TRD). Methods to confirm optimal target engagement in this heterogenous region are now critical to establish an objective treatment protocol. As yet unexamined are the time-frequency features of the SCC evoked potential (SCC-EP), including spectral power and phase-clustering. We examined these spectral features—evoked power and phase clustering—in a sample of TRD patients (n = 8) with implanted SCC stimulators. Electroencephalogram (EEG) was recorded during wakeful rest. Location of electrical stimulation in the SCC target region was the experimental manipulation. EEG was analyzed at the surface level with an average reference for a cluster of frontal sensors and at a time window identified by prior study (50–150 ms). Morlet wavelets generated indices of evoked power and inter-trial phase clustering. Enhanced phase clustering at theta frequency (4–7 Hz) was observed in every subject and was significantly correlated with SCC-EP magnitude, but only during left SCC stimulation. Stimulation to dorsal SCC evinced stronger phase clustering than ventral SCC. There was a weak correlation between phase clustering and white matter density. An increase in evoked delta power (2–4 Hz) was also coincident with SCC-EP, but was less consistent across participants. DBS evoked time-frequency features index mm-scale changes to the location of stimulation in the SCC target region and correlate with structural characteristics implicated in treatment optimization. Results also imply a shared generative mechanism (inter-trial phase clustering) between evoked potentials evinced by electrical stimulation and evoked potentials evinced by auditory/visual stimuli and behavioral tasks. Understanding how current injection impacts downstream cortical activity is essential to building new technologies that adapt treatment parameters to individual differences in neurophysiology.
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Affiliation(s)
| | - Ki Sueng Choi
- Departments of Psychiatry, Neuroscience, Neurology, Neurosurgery and Radiology, Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ashan Veerakumar
- Department of Psychiatry, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Mosadoluwa Obatusin
- Departments of Psychiatry, Neuroscience, Neurology, Neurosurgery and Radiology, Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Bryan Howell
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Andrew H. Smith
- Departments of Psychiatry, Neuroscience, Neurology, Neurosurgery and Radiology, Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Vineet Tiruvadi
- Emory University School of Medicine, Atlanta, GA, United States
- Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, GA, United States
| | - Andrea L. Crowell
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Sankaraleengam Alagapan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Christopher J. Rozell
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Helen S. Mayberg
- Departments of Psychiatry, Neuroscience, Neurology, Neurosurgery and Radiology, Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Allison C. Waters
- Departments of Psychiatry, Neuroscience, Neurology, Neurosurgery and Radiology, Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- *Correspondence: Allison C. Waters,
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28
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Visser-Vandewalle V, Andrade P, Mosley PE, Greenberg BD, Schuurman R, McLaughlin NC, Voon V, Krack P, Foote KD, Mayberg HS, Figee M, Kopell BH, Polosan M, Joyce EM, Chabardes S, Matthews K, Baldermann JC, Tyagi H, Holtzheimer PE, Bervoets C, Hamani C, Karachi C, Denys D, Zrinzo L, Blomstedt P, Naesström M, Abosch A, Rasmussen S, Coenen VA, Schlaepfer TE, Dougherty DD, Domenech P, Silburn P, Giordano J, Lozano AM, Sheth SA, Coyne T, Kuhn J, Mallet L, Nuttin B, Hariz M, Okun MS. Deep brain stimulation for obsessive-compulsive disorder: a crisis of access. Nat Med 2022; 28:1529-1532. [PMID: 35840727 DOI: 10.1038/s41591-022-01879-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany.
| | - Pablo Andrade
- Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Philip E Mosley
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, and Queensland Brain Institute, Brisbane, Queensland, Australia
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Center for Neuromodulation, Butler Hospital, Providence, RI, USA.,RR&D Center for Neurorestoration and Neurotechnology, Providence, RI, USA
| | - Rick Schuurman
- Department of Neurosurgery, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Nicole C McLaughlin
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Behavioral Medicine and Addictions Research, Butler Hospital, Providence, Rhode Island, USA
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Kelly D Foote
- Department of Neurosurgery, University of Florida Health, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France.,Centre Expert Troubles Bipolaires, Service Universitaire de Psychiatrie, Centre Hospitalier Universitaire de Grenoble et des Alpes, Grenoble, France.,Grenoble Institut des Neurosciences, Inserm U 836, La Tronche, France
| | - Eileen M Joyce
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble University Hospital, Grenoble, France
| | - Keith Matthews
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, UK
| | - Juan C Baldermann
- Department of Neurology, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Himanshu Tyagi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Paul E Holtzheimer
- Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Chris Bervoets
- Department of Neurosciences, Adult Psychiatry, UPC KU Leuven, Leuven, Belgium
| | - Clement Hamani
- Sunnybrook Research Institute, Division of Neurosurgery, University of Toronto, Toronto, Canada
| | - Carine Karachi
- Neurosurgery Department, Hôpital de la Salpêtrière, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | | | - Matilda Naesström
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
| | - Aviva Abosch
- Department of Neurosurgery and Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Steven Rasmussen
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.,Carney Institute for Brain Science, Brown University, Providence, RI, USA
| | - Volker A Coenen
- Department of Stereotactic and Functional Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Deep Brain Stimulation, Freiburg University, Freiburg, Germany
| | - Thomas E Schlaepfer
- Department of Stereotactic and Functional Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Deep Brain Stimulation, Freiburg University, Freiburg, Germany
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Philippe Domenech
- Département Médico-Universitaire de Psychiatrie et d'Addictologie, Assistance Publique-Hôpitaux de Paris, Le Groupe Hospitalier Universitaire Henri Mondor, Université Paris-Est, Créteil, France.,Institut du Cerveau, Inserm U1127, CNRS UMR7225, Sorbonne Université, Paris, France
| | - Peter Silburn
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - James Giordano
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA.,Department of Biochemistry and Molecular & Cellular Biology, Georgetown University, Washington, DC, USA.,Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, Georgetown University, Washington, DC, USA
| | - Andres M Lozano
- Department of Neurosurgery and Neuroscience, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Terry Coyne
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Johanniter Hospital Oberhausen, Oberhausen, Germany
| | - Luc Mallet
- Département Médical-Universitaire de Psychiatrie et d'Addictologie, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, University Paris-Est Créteil, Créteil, France.,Institut du Cerveau, Paris Brain Institute, Inserm, CNRS, Sorbonne Université, Paris, France.,Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland
| | - Bart Nuttin
- Department of Neurosurgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Marwan Hariz
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Unit for Deep Brain Stimulation, Umeå University, Umeå, Sweden
| | - Michael S Okun
- Department of Neurosurgery, University of Florida Health, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA.,Department of Neurology, University of Florida Health, Gainesville, FL, USA
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29
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Figee M, Riva-Posse P, Choi KS, Bederson L, Mayberg HS, Kopell BH. Deep Brain Stimulation for Depression. Neurotherapeutics 2022; 19:1229-1245. [PMID: 35817944 PMCID: PMC9587188 DOI: 10.1007/s13311-022-01270-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
Deep brain stimulation has been extensively studied as a therapeutic option for treatment-resistant depression (TRD). DBS across different targets is associated with on average 60% response rates in previously refractory chronically depressed patients. However, response rates vary greatly between patients and between studies and often require extensive trial-and-error optimizations of stimulation parameters. Emerging evidence from tractography imaging suggests that targeting combinations of white matter tracts, rather than specific grey matter regions, is necessary for meaningful antidepressant response to DBS. In this article, we review efficacy of various DBS targets for TRD, which networks are involved in their therapeutic effects, and how we can use this information to improve targeting and programing of DBS for individual patients. We will also highlight how to integrate these DBS network findings into developing adaptive stimulation and optimal trial designs.
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Affiliation(s)
- Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Georgia, GA, USA
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lucia Bederson
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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30
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Brydges CR, Bhattacharyya S, Dehkordi SM, Milaneschi Y, Penninx B, Jansen R, Kristal BS, Han X, Arnold M, Kastenmüller G, Bekhbat M, Mayberg HS, Craighead WE, Rush AJ, Fiehn O, Dunlop BW, Kaddurah-Daouk R. Metabolomic and inflammatory signatures of symptom dimensions in major depression. Brain Behav Immun 2022; 102:42-52. [PMID: 35131442 PMCID: PMC9241382 DOI: 10.1016/j.bbi.2022.02.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/25/2022] [Accepted: 02/01/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly heterogenous disease, both in terms of clinical profiles and pathobiological alterations. Recently, immunometabolic dysregulations were shown to be correlated with atypical, energy-related symptoms but less so with the Melancholic or Anxious distress symptom dimensions of depression in The Netherlands Study of Depression and Anxiety (NESDA) study. In this study, we aimed to replicate these immunometabolic associations and to characterize the metabolomic correlates of each of the three MDD dimensions. METHODS Using three clinical rating scales, Melancholic, and Anxious distress, and Immunometabolic (IMD) dimensions were characterized in 158 patients who participated in the Predictors of Remission to Individual and Combined Treatments (PReDICT) study and from whom plasma and serum samples were available. The NESDA-defined inflammatory index, a composite measure of interleukin-6 and C-reactive protein, was measured from pre-treatment plasma samples and a metabolomic profile was defined using serum samples analyzed on three metabolomics platforms targeting fatty acids and complex lipids, amino acids, acylcarnitines, and gut microbiome-derived metabolites among other metabolites of central metabolism. RESULTS The IMD clinical dimension and the inflammatory index were positively correlated (r = 0.19, p = 0.019) after controlling for age, sex, and body mass index, whereas the Melancholic and Anxious distress dimensions were not, replicating the previous NESDA findings. The three symptom dimensions had distinct metabolomic signatures using both univariate and set enrichment statistics. IMD severity correlated mainly with gut-derived metabolites and a few acylcarnitines and long chain saturated free fatty acids. Melancholia severity was significantly correlated with several phosphatidylcholines, primarily the ether-linked variety, lysophosphatidylcholines, as well as several amino acids. Anxious distress severity correlated with several medium and long chain free fatty acids, both saturated and polyunsaturated ones, sphingomyelins, as well as several amino acids and bile acids. CONCLUSION The IMD dimension of depression appears reliably associated with markers of inflammation. Metabolomics provides powerful tools to inform about depression heterogeneity and molecular mechanisms related to clinical dimensions in MDD, which include a link to gut microbiome and lipids implicated in membrane structure and function.
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Affiliation(s)
| | - Sudeepa Bhattacharyya
- Arkansas Biosciences Institute, Department of Biological Sciences, Arkansas State University, AR, USA
| | | | - Yuri Milaneschi
- Amsterdam UMC / GGZ inGeest Research & Innovation, Amsterdam, Netherlands
| | - Brenda Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands
| | - Rick Jansen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands; Department of Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Bruce S Kristal
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Xianlin Han
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Matthias Arnold
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Gabi Kastenmüller
- Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Mandakh Bekhbat
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Psychology, Emory University, Atlanta, GA, USA
| | - A John Rush
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry, Health Sciences Center, Texas Tech University, Permian Basin, TX, USA; Duke-National University of Singapore, Singapore
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California, Davis, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University, Durham, NC, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC, USA.
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31
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Poline JB, Kennedy DN, Sommer FT, Ascoli GA, Van Essen DC, Ferguson AR, Grethe JS, Hawrylycz MJ, Thompson PM, Poldrack RA, Ghosh SS, Keator DB, Athey TL, Vogelstein JT, Mayberg HS, Martone ME. Is Neuroscience FAIR? A Call for Collaborative Standardisation of Neuroscience Data. Neuroinformatics 2022; 20:507-512. [PMID: 35061216 PMCID: PMC9300762 DOI: 10.1007/s12021-021-09557-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/25/2022]
Abstract
In this perspective article, we consider the critical issue of data and other research object standardisation and, specifically, how international collaboration, and organizations such as the International Neuroinformatics Coordinating Facility (INCF) can encourage that emerging neuroscience data be Findable, Accessible, Interoperable, and Reusable (FAIR). As neuroscientists engaged in the sharing and integration of multi-modal and multiscale data, we see the current insufficiency of standards as a major impediment in the Interoperability and Reusability of research results. We call for increased international collaborative standardisation of neuroscience data to foster integration and efficient reuse of research objects.
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Affiliation(s)
- Jean-Baptiste Poline
- Faculty of Medicine, Jr. Brain Imaging Center, McGill UniversityMontreal Canada and Henry H. WheelerHelen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA USA
| | - David N. Kennedy
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA USA
| | - Friedrich T. Sommer
- Redwood Center for Theoretical Neuroscience, University of California, Berkeley, CA USA
| | - Giorgio A. Ascoli
- Bioengineering Department, Neuroscience Program, and Center for Neural Informatics, Structures, and Plasticity; Volgenau School of Engineering and Krasnow Institute for Advanced Study, George Mason University, Fairfax, VA USA
| | - David C. Van Essen
- Anatomy & Neurobiology Department, Washington University in St. Louis, St. Louis, MO USA
| | - Adam R. Ferguson
- Brain and Spinal Injury Center, UCSF, University of California San Francisco School of Medicine, San Francisco, CA USA
| | - Jeffrey S. Grethe
- Center for Research in Biological Systems, University of California, San Diego, CA USA
| | | | - Paul M. Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Russell A. Poldrack
- Department of Psychology and Stanford Center for Reproducible Neuroscience, Stanford University, Stanford, CA 94305 USA
| | | | | | - Thomas L. Athey
- Center for Imaging Science, Department of Biomedical Engineering, Johns Hopkins University, Maryland Baltimore, USA
| | - Joshua T. Vogelstein
- Institute for Computational Medicine, Center for Imaging Science, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland USA
| | - Helen S. Mayberg
- Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Maryann E. Martone
- Department of Neurosciences, University of California, San Diego, La Jolla, CA 92093-0662 USA
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32
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 239] [Impact Index Per Article: 119.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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Wong JK, Deuschl G, Wolke R, Bergman H, Muthuraman M, Groppa S, Sheth SA, Bronte-Stewart HM, Wilkins KB, Petrucci MN, Lambert E, Kehnemouyi Y, Starr PA, Little S, Anso J, Gilron R, Poree L, Kalamangalam GP, Worrell GA, Miller KJ, Schiff ND, Butson CR, Henderson JM, Judy JW, Ramirez-Zamora A, Foote KD, Silburn PA, Li L, Oyama G, Kamo H, Sekimoto S, Hattori N, Giordano JJ, DiEuliis D, Shook JR, Doughtery DD, Widge AS, Mayberg HS, Cha J, Choi K, Heisig S, Obatusin M, Opri E, Kaufman SB, Shirvalkar P, Rozell CJ, Alagapan S, Raike RS, Bokil H, Green D, Okun MS. Proceedings of the Ninth Annual Deep Brain Stimulation Think Tank: Advances in Cutting Edge Technologies, Artificial Intelligence, Neuromodulation, Neuroethics, Pain, Interventional Psychiatry, Epilepsy, and Traumatic Brain Injury. Front Hum Neurosci 2022; 16:813387. [PMID: 35308605 PMCID: PMC8931265 DOI: 10.3389/fnhum.2022.813387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/11/2022] [Indexed: 01/09/2023] Open
Abstract
DBS Think Tank IX was held on August 25-27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers (from industry and academia) can freely discuss current and emerging deep brain stimulation (DBS) technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year's meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury.
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Affiliation(s)
- Joshua K. Wong
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Günther Deuschl
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Robin Wolke
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Hagai Bergman
- Department of Medical Neurobiology (Physiology), Institute of Medical Research Israel-Canada, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Muthuraman Muthuraman
- Biomedical Statistics and Multimodal Signal Processing Unit, Section of Movement Disorders and Neurostimulation, Focus Program Translational Neuroscience, Department of Neurology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Biomedical Statistics and Multimodal Signal Processing Unit, Section of Movement Disorders and Neurostimulation, Focus Program Translational Neuroscience, Department of Neurology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sameer A. Sheth
- Department of Neurological Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Helen M. Bronte-Stewart
- The Human Motor Control and Neuromodulation Laboratory, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, United States
| | - Kevin B. Wilkins
- The Human Motor Control and Neuromodulation Laboratory, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, United States
| | - Matthew N. Petrucci
- The Human Motor Control and Neuromodulation Laboratory, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, United States
| | - Emilia Lambert
- The Human Motor Control and Neuromodulation Laboratory, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, United States
| | - Yasmine Kehnemouyi
- The Human Motor Control and Neuromodulation Laboratory, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, United States
| | - Philip A. Starr
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Simon Little
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Juan Anso
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Ro’ee Gilron
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Lawrence Poree
- Department of Anesthesia, University of California, San Francisco, San Francisco, CA, United States
| | - Giridhar P. Kalamangalam
- Department of Neurology, Wilder Center for Epilepsy Research, University of Florida, Gainesville, FL, United States
| | | | - Kai J. Miller
- Department of Neurosurgery, Mayo Clinic, Rochester, NY, United States
| | - Nicholas D. Schiff
- Department of Neurology, Weill Cornell Brain and Spine Institute, Weill Cornell Medicine, New York, NY, United States
| | - Christopher R. Butson
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Jaimie M. Henderson
- Department of Neurosurgery, Stanford University, Stanford, CA, United States
| | - Jack W. Judy
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, United States
| | - Adolfo Ramirez-Zamora
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Kelly D. Foote
- Department of Neurosurgery, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Peter A. Silburn
- Queensland Brain Institute, University of Queensland and Saint Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - Luming Li
- National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
| | - Genko Oyama
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Hikaru Kamo
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Satoko Sekimoto
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - James J. Giordano
- Neuroethics Studies Program, Department of Neurology, Georgetown University Medical Center, Washington, DC, United States
| | - Diane DiEuliis
- US Department of Defense Fort Lesley J. McNair, National Defense University, Washington, DC, United States
| | - John R. Shook
- Department of Philosophy and Science Education, University of Buffalo, Buffalo, NY, United States
| | - Darin D. Doughtery
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Alik S. Widge
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Helen S. Mayberg
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jungho Cha
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kisueng Choi
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stephen Heisig
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Mosadolu Obatusin
- Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Enrico Opri
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Scott B. Kaufman
- Department of Psychology, Columbia University, New York, NY, United States
| | - Prasad Shirvalkar
- The Human Motor Control and Neuromodulation Laboratory, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, United States
- Department of Anesthesiology (Pain Management) and Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Christopher J. Rozell
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Sankaraleengam Alagapan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Robert S. Raike
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic Inc., Minneapolis, MN, United States
| | - Hemant Bokil
- Boston Scientific Neuromodulation Corporation, Valencia, CA, United States
| | - David Green
- NeuroPace, Inc., Mountain View, CA, United States
| | - Michael S. Okun
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
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34
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Avecillas-Chasin JM, Choi KS, Mayberg HS, Figee M, Kopell BH. 201 Tractography Analysis of Deep Brain Stimulation for Obsessive-Compulsive Disorder. Neurosurgery 2022. [DOI: 10.1227/neu.0000000000001880_201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abrams MB, Bjaalie JG, Das S, Egan GF, Ghosh SS, Goscinski WJ, Grethe JS, Kotaleski JH, Ho ETW, Kennedy DN, Lanyon LJ, Leergaard TB, Mayberg HS, Milanesi L, Mouček R, Poline JB, Roy PK, Strother SC, Tang TB, Tiesinga P, Wachtler T, Wójcik DK, Martone ME. A Standards Organization for Open and FAIR Neuroscience: the International Neuroinformatics Coordinating Facility. Neuroinformatics 2022; 20:25-36. [PMID: 33506383 PMCID: PMC9036053 DOI: 10.1007/s12021-020-09509-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 01/07/2023]
Abstract
There is great need for coordination around standards and best practices in neuroscience to support efforts to make neuroscience a data-centric discipline. Major brain initiatives launched around the world are poised to generate huge stores of neuroscience data. At the same time, neuroscience, like many domains in biomedicine, is confronting the issues of transparency, rigor, and reproducibility. Widely used, validated standards and best practices are key to addressing the challenges in both big and small data science, as they are essential for integrating diverse data and for developing a robust, effective, and sustainable infrastructure to support open and reproducible neuroscience. However, developing community standards and gaining their adoption is difficult. The current landscape is characterized both by a lack of robust, validated standards and a plethora of overlapping, underdeveloped, untested and underutilized standards and best practices. The International Neuroinformatics Coordinating Facility (INCF), an independent organization dedicated to promoting data sharing through the coordination of infrastructure and standards, has recently implemented a formal procedure for evaluating and endorsing community standards and best practices in support of the FAIR principles. By formally serving as a standards organization dedicated to open and FAIR neuroscience, INCF helps evaluate, promulgate, and coordinate standards and best practices across neuroscience. Here, we provide an overview of the process and discuss how neuroscience can benefit from having a dedicated standards body.
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Affiliation(s)
| | - Jan G. Bjaalie
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Samir Das
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, QC Canada
| | - Gary F. Egan
- Monash Biomedical Imaging, Monash University, Clayton, VIC Australia
| | - Satrajit S. Ghosh
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA USA ,Department of Otolaryngology - Head and Neck Surgery Harvard Medical School Boston, Boston, MA USA
| | | | - Jeffrey S. Grethe
- Department of Neuroscience, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | | | - Eric Tatt Wei Ho
- Centre for Intelligent Signal and Imaging Research, Institute of Health and Analytics, Universiti Teknologi PETRONAS, Perak, Malaysia
| | - David N. Kennedy
- Department of Psychiatry, University of Massachusetts Medical School, Worchester, MA USA
| | | | | | - Helen S. Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY USA
| | - Luciano Milanesi
- Institute of Biomedical Technologies, National Research Council (CNR), Milan, Italy
| | - Roman Mouček
- Department of Computer Science and Engineering, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - J. B. Poline
- Montreal Neurological Institute, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Prasun K. Roy
- Computational Neuroscience & Neuroimaging Laboratory, School of Bio-Medical Engineering, Indian Institute of Technology (BHU), Varanasi, UP India
| | - Stephen C. Strother
- Rotman Research Institute, Baycrest Centre, Department of Medical Biophysics, University of Toronto, Ontario, ON Canada
| | - Tong Boon Tang
- Centre for Intelligent Signal and Imaging Research, Institute of Health and Analytics, Universiti Teknologi PETRONAS, Bandar Seri Iskandar, Malaysia
| | - Paul Tiesinga
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Thomas Wachtler
- Department of Biology II, Ludwig-Maximilians-Universität München, Martinsried, Planegg Germany
| | - Daniel K. Wójcik
- Laboratory of Neuroinformatics, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Maryann E. Martone
- Department of Neuroscience, School of Medicine, University of California, San Diego, La Jolla, CA USA
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Vedam-Mai V, Deisseroth K, Giordano J, Lazaro-Munoz G, Chiong W, Suthana N, Langevin JP, Gill J, Goodman W, Provenza NR, Halpern CH, Shivacharan RS, Cunningham TN, Sheth SA, Pouratian N, Scangos KW, Mayberg HS, Horn A, Johnson KA, Butson CR, Gilron R, de Hemptinne C, Wilt R, Yaroshinsky M, Little S, Starr P, Worrell G, Shirvalkar P, Chang E, Volkmann J, Muthuraman M, Groppa S, Kühn AA, Li L, Johnson M, Otto KJ, Raike R, Goetz S, Wu C, Silburn P, Cheeran B, Pathak YJ, Malekmohammadi M, Gunduz A, Wong JK, Cernera S, Hu W, Wagle Shukla A, Ramirez-Zamora A, Deeb W, Patterson A, Foote KD, Okun MS. Corrigendum: Proceedings of the Eighth Annual Deep Brain Stimulation Think Tank: Advances in Optogenetics, Ethical Issues Affecting DBS Research, Neuromodulatory Approaches for Depression, Adaptive Neurostimulation, and Emerging DBS Technologies. Front Hum Neurosci 2021; 15:765150. [PMID: 34658825 PMCID: PMC8517517 DOI: 10.3389/fnhum.2021.765150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Vinata Vedam-Mai
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Karl Deisseroth
- Department of Bioengineering, Stanford University, Stanford, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - James Giordano
- Department of Neurology and Neuroethics Studies Program, Georgetown University Medical Center, Washington, DC, United States
| | - Gabriel Lazaro-Munoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Winston Chiong
- Weill Institute for Neurosciences, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Nanthia Suthana
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jean-Philippe Langevin
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Neurosurgery Service, Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Jay Gill
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Wayne Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Nicole R Provenza
- School of Engineering, Brown University, Providence, RI, United States
| | - Casey H Halpern
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Rajat S Shivacharan
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Tricia N Cunningham
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Sameer A Sheth
- Department of Neurological Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Nader Pouratian
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine W Scangos
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Helen S Mayberg
- Department of Neurology and Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Andreas Horn
- Movement Disorders & Neuromodulation Unit, Department for Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - Kara A Johnson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States.,Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
| | - Christopher R Butson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States.,Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
| | - Ro'ee Gilron
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Coralie de Hemptinne
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Robert Wilt
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Maria Yaroshinsky
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Simon Little
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Philip Starr
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Greg Worrell
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Prasad Shirvalkar
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States.,Department of Anesthesiology (Pain Management) and Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Edward Chang
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Jens Volkmann
- Neurologischen Klinik Universitätsklinikum Würzburg, Würzburg, Germany
| | - Muthuraman Muthuraman
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Focus Program Translational Neuroscience, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Focus Program Translational Neuroscience, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Luming Li
- National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
| | - Matthew Johnson
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Kevin J Otto
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Robert Raike
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic, Minneapolis, MN, United States
| | - Steve Goetz
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic, Minneapolis, MN, United States
| | - Chengyuan Wu
- Department of Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, United States
| | - Peter Silburn
- Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Binith Cheeran
- Neuromodulation Division, Abbott, Plano, TX, United States
| | - Yagna J Pathak
- Neuromodulation Division, Abbott, Plano, TX, United States
| | | | - Aysegul Gunduz
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Joshua K Wong
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Stephanie Cernera
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Wei Hu
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Aparna Wagle Shukla
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Adolfo Ramirez-Zamora
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Wissam Deeb
- Department of Neurology, University of Massachusetts, Worchester, MA, United States
| | - Addie Patterson
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Kelly D Foote
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
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Zhu Z, Hubbard E, Guo X, Barbosa DAN, Popal AM, Cai C, Jiang H, Zheng Z, Lin J, Gao W, Zhang J, Bartas K, Macchia D, Derdeyn P, Halpern CH, Mayberg HS, Beier KT, Zhu J, Wu H. A connectomic analysis of deep brain stimulation for treatment-resistant depression. Brain Stimul 2021; 14:1226-1233. [PMID: 34400379 DOI: 10.1016/j.brs.2021.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Deep brain stimulation (DBS) has been used as a treatment of last resort for treatment-resistant depression (TRD) for more than a decade. Many DBS targets have been proposed and tested clinically, but the underlying circuit mechanisms remain unclear. Uncovering white matter tracts (WMT) activated by DBS targets may provide crucial information about the circuit substrates mediating DBS efficacy in ameliorating TRD. METHODS We performed probabilistic tractography using diffusion magnetic resonance imaging datas from 100 healthy volunteers in Human Connectome Project datasets to analyze the structural connectivity patterns of stimulation targeting currently-used DBS target for TRD. We generated mean and binary fiber distribution maps and calculated the numbers of WMT streamlines in the dataset. RESULTS Probabilistic tracking results revealed that activation of distinct DBS targets demonstrated modulation of overlapping but considerably distinct pathways. DBS targets were categorized into 4 groups: Cortical, Striatal, Thalamic, and Medial Forebrain Bundle according to their main modulated WMT and brain areas. Our data also revealed that Brodmann area 10 and amygdala are hub structures that are associated with all DBS targets. CONCLUSIONS Our results together suggest that the distinct mechanism of DBS targets implies individualized target selection and formulation in the future of DBS treatment for TRD. The modulation of Brodmann area 10 and amygdala may be critical for the efficacy of DBS-mediated treatment of TRD.
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Affiliation(s)
- Zhoule Zhu
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Elizabeth Hubbard
- Department of Physiology and Biophysics, University of California, Irvine, CA, 92697-4560, USA
| | - Xinxia Guo
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Daniel A N Barbosa
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Abdul Malik Popal
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Chengwei Cai
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Hongjie Jiang
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Zhe Zheng
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Jingquan Lin
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Wei Gao
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Jianmin Zhang
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China
| | - Katrina Bartas
- Program in Mathematical, Computational, and Systems Biology, University of California, Irvine, CA, 92697-4560, USA
| | - Desiree Macchia
- Department of Physiology and Biophysics, University of California, Irvine, CA, 92697-4560, USA
| | - Pieter Derdeyn
- Program in Mathematical, Computational, and Systems Biology, University of California, Irvine, CA, 92697-4560, USA
| | - Casey H Halpern
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Helen S Mayberg
- Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Kevin T Beier
- Department of Physiology and Biophysics, University of California, Irvine, CA, 92697-4560, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, 92697-4560, USA; Department of Biomedical Engineering, University of California, Irvine, CA, 92697-4560, USA; Department of Pharmaceutical Sciences, University of California, Irvine, CA, 92697-4560, USA; Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, 92697, USA.
| | - Junming Zhu
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China.
| | - Hemmings Wu
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, China.
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Kelley ME, Choi KS, Rajendra JK, Craighead WE, Rakofsky JJ, Dunlop BW, Mayberg HS. Establishing Evidence for Clinical Utility of a Neuroimaging Biomarker in Major Depressive Disorder: Prospective Testing and Implementation Challenges. Biol Psychiatry 2021; 90:236-242. [PMID: 33896622 PMCID: PMC8324510 DOI: 10.1016/j.biopsych.2021.02.966] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/25/2021] [Accepted: 02/12/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although a number of neuroimaging biomarkers for response have been proposed, none have been tested prospectively for direct effects on treatment outcomes. To the best of our knowledge, this is the first prospective test of the clinical utility of the use of an imaging biomarker to select treatment for patients with major depressive disorder. METHODS Eligible participants (n = 60) had a primary diagnosis of major depressive disorder and were assigned to either escitalopram or cognitive behavioral therapy based on fluorodeoxyglucose positron emission tomography activity in the right anterior insula. The overall study remission rate after 12 weeks of treatment, based on the end point Hamilton Depression Rating Scale score, was then examined for futility and benefit of the strategy. RESULTS Remission rates demonstrated lack of futility at the end of stage 1 (37%, 10/27), and the study proceeded to stage 2. After adjustment for the change in stage 2 sample size, the complete remission rate did not demonstrate evidence of benefit (37.7%, 95% confidence interval, 26.3%-51.4%, p = .38). However, total remission rates (complete and partial remission) did reach significance in post hoc analysis (49.1%, 95% confidence interval, 37.6%-60.7%, p = .020). CONCLUSIONS The study shows some evidence for a role of the right anterior insula in the clinical choice of major depressive disorder monotherapy. The effect size, however, is insufficient for the use of insula activity as a sole predictive biomarker of remission. The study also demonstrates the logistical difficulties in establishing clinical utility of biomarkers.
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Affiliation(s)
- Mary E. Kelley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ki Sueng Choi
- Center for Advanced Circuit Therapeutics , Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Justin K. Rajendra
- Scientific and Statistical Computing Core, NIMH/NIH/DHHS, Bethesda, Maryland, USA
| | - W. Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.,Department of Psychology, Emory University, Atlanta, GA, USA
| | - Jeffrey J. Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Boadie W. Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Helen S. Mayberg
- Center for Advanced Circuit Therapeutics , Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Das RR, Goss AL, Richie M, Geocadin RG, Mayberg HS. ANA Investigates: Neural Circuit Concepts Connecting Neurology and Psychiatry. Ann Neurol 2021; 90:568-569. [PMID: 34378220 DOI: 10.1002/ana.26190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/27/2021] [Accepted: 08/01/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Rohit R Das
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX
| | - Adeline L Goss
- Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Megan Richie
- Department of Neurology, University of California San Francisco, San Francisco, CA
| | | | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY
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40
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Dini H, Sendi MSE, Sui J, Fu Z, Espinoza R, Narr KL, Qi S, Abbott CC, van Rooij SJH, Riva-Posse P, Bruni LE, Mayberg HS, Calhoun VD. Dynamic Functional Connectivity Predicts Treatment Response to Electroconvulsive Therapy in Major Depressive Disorder. Front Hum Neurosci 2021; 15:689488. [PMID: 34295231 PMCID: PMC8291148 DOI: 10.3389/fnhum.2021.689488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder. Recently, there has been increasing attention to evaluate the effect of ECT on resting-state functional magnetic resonance imaging (rs-fMRI). This study aims to compare rs-fMRI of depressive disorder (DEP) patients with healthy participants, investigate whether pre-ECT dynamic functional network connectivity network (dFNC) estimated from patients rs-fMRI is associated with an eventual ECT outcome, and explore the effect of ECT on brain network states. Method: Resting-state functional magnetic resonance imaging (fMRI) data were collected from 119 patients with depression or depressive disorder (DEP) (76 females), and 61 healthy (HC) participants (34 females), with an age mean of 52.25 (N = 180) years old. The pre-ECT and post-ECT Hamilton Depression Rating Scale (HDRS) were 25.59 ± 6.14 and 11.48 ± 9.07, respectively. Twenty-four independent components from default mode (DMN) and cognitive control network (CCN) were extracted, using group-independent component analysis from pre-ECT and post-ECT rs-fMRI. Then, the sliding window approach was used to estimate the pre-and post-ECT dFNC of each subject. Next, k-means clustering was separately applied to pre-ECT dFNC and post-ECT dFNC to assess three distinct states from each participant. We calculated the amount of time each subject spends in each state, which is called “occupancy rate” or OCR. Next, we compared OCR values between HC and DEP participants. We also calculated the partial correlation between pre-ECT OCRs and HDRS change while controlling for age, gender, and site. Finally, we evaluated the effectiveness of ECT by comparing pre- and post-ECT OCR of DEP and HC participants. Results: The main findings include (1) depressive disorder (DEP) patients had significantly lower OCR values than the HC group in state 2, where connectivity between cognitive control network (CCN) and default mode network (DMN) was relatively higher than other states (corrected p = 0.015), (2) Pre-ECT OCR of state, with more negative connectivity between CCN and DMN components, is linked with the HDRS changes (R = 0.23 corrected p = 0.03). This means that those DEP patients who spent less time in this state showed more HDRS change, and (3) The post-ECT OCR analysis suggested that ECT increased the amount of time DEP patients spent in state 2 (corrected p = 0.03). Conclusion: Our finding suggests that dynamic functional network connectivity (dFNC) features, estimated from CCN and DMN, show promise as a predictive biomarker of the ECT outcome of DEP patients. Also, this study identifies a possible underlying mechanism associated with the ECT effect on DEP patients.
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Affiliation(s)
- Hossein Dini
- Department of Architecture, Design and Media Technology, Aalborg University, Copenhagen, Denmark
| | - Mohammad S E Sendi
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, GA, United States.,Department of Electrical and Computer Engineering at Georgia Institute of Technology, Atlanta, GA, United States.,Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
| | - Jing Sui
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zening Fu
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
| | - Randall Espinoza
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine L Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shile Qi
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
| | - Christopher C Abbott
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, United States
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Luis Emilio Bruni
- Department of Architecture, Design and Media Technology, Aalborg University, Copenhagen, Denmark
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Vince D Calhoun
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, GA, United States.,Department of Electrical and Computer Engineering at Georgia Institute of Technology, Atlanta, GA, United States.,Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
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Vedam-Mai V, Deisseroth K, Giordano J, Lazaro-Munoz G, Chiong W, Suthana N, Langevin JP, Gill J, Goodman W, Provenza NR, Halpern CH, Shivacharan RS, Cunningham TN, Sheth SA, Pouratian N, Scangos KW, Mayberg HS, Horn A, Johnson KA, Butson CR, Gilron R, de Hemptinne C, Wilt R, Yaroshinsky M, Little S, Starr P, Worrell G, Shirvalkar P, Chang E, Volkmann J, Muthuraman M, Groppa S, Kühn AA, Li L, Johnson M, Otto KJ, Raike R, Goetz S, Wu C, Silburn P, Cheeran B, Pathak YJ, Malekmohammadi M, Gunduz A, Wong JK, Cernera S, Wagle Shukla A, Ramirez-Zamora A, Deeb W, Patterson A, Foote KD, Okun MS. Proceedings of the Eighth Annual Deep Brain Stimulation Think Tank: Advances in Optogenetics, Ethical Issues Affecting DBS Research, Neuromodulatory Approaches for Depression, Adaptive Neurostimulation, and Emerging DBS Technologies. Front Hum Neurosci 2021; 15:644593. [PMID: 33953663 PMCID: PMC8092047 DOI: 10.3389/fnhum.2021.644593] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/10/2021] [Indexed: 12/20/2022] Open
Abstract
We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank.
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Affiliation(s)
- Vinata Vedam-Mai
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Karl Deisseroth
- Department of Bioengineering, Stanford University, Stanford, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - James Giordano
- Department of Neurology and Neuroethics Studies Program, Georgetown University Medical Center, Washington, DC, United States
| | - Gabriel Lazaro-Munoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Winston Chiong
- Weill Institute for Neurosciences, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Nanthia Suthana
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jean-Philippe Langevin
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Neurosurgery Service, Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Jay Gill
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Wayne Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Nicole R Provenza
- School of Engineering, Brown University, Providence, RI, United States
| | - Casey H Halpern
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Rajat S Shivacharan
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Tricia N Cunningham
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Sameer A Sheth
- Department of Neurological Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Nader Pouratian
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine W Scangos
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Helen S Mayberg
- Department of Neurology and Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Andreas Horn
- Movement Disorders & Neuromodulation Unit, Department for Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - Kara A Johnson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States.,Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
| | - Christopher R Butson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States.,Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
| | - Ro'ee Gilron
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Coralie de Hemptinne
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Robert Wilt
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Maria Yaroshinsky
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Simon Little
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Philip Starr
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Greg Worrell
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Prasad Shirvalkar
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States.,Department of Anesthesiology (Pain Management) and Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Edward Chang
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Jens Volkmann
- Neurologischen Klinik Universitätsklinikum Würzburg, Würzburg, Germany
| | - Muthuraman Muthuraman
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Focus Program Translational Neuroscience, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Focus Program Translational Neuroscience, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Luming Li
- National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
| | - Matthew Johnson
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Kevin J Otto
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Robert Raike
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic, Minneapolis, MN, United States
| | - Steve Goetz
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic, Minneapolis, MN, United States
| | - Chengyuan Wu
- Department of Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, United States
| | - Peter Silburn
- Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Binith Cheeran
- Neuromodulation Division, Abbott, Plano, TX, United States
| | - Yagna J Pathak
- Neuromodulation Division, Abbott, Plano, TX, United States
| | | | - Aysegul Gunduz
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Joshua K Wong
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Stephanie Cernera
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Aparna Wagle Shukla
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Adolfo Ramirez-Zamora
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Wissam Deeb
- Department of Neurology, University of Massachusetts, Worchester, MA, United States
| | - Addie Patterson
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Kelly D Foote
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
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Jiang Z, Harati S, Crowell A, Mayberg HS, Nemati S, Clifford GD. Classifying Major Depressive Disorder and Response to Deep Brain Stimulation Over Time by Analyzing Facial Expressions. IEEE Trans Biomed Eng 2021; 68:664-672. [PMID: 32746065 PMCID: PMC7891869 DOI: 10.1109/tbme.2020.3010472] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is a common psychiatric disorder that leads to persistent changes in mood and interest among other signs and symptoms. We hypothesized that convolutional neural network (CNN) based automated facial expression recognition, pre-trained on an enormous auxiliary public dataset, could provide improve generalizable approach to MDD automatic assessment from videos, and classify remission or response to treatment. METHODS We evaluated a novel deep neural network framework on 365 video interviews (88 hours) from a cohort of 12 depressed patients before and after deep brain stimulation (DBS) treatment. Seven basic emotions were extracted with a Regional CNN detector and an Imagenet pre-trained CNN, both of which were trained on large-scale public datasets (comprising over a million images). Facial action units were also extracted with the Openface toolbox. Statistics of the temporal evolution of these image features over each recording were extracted and used to classify MDD remission and response to DBS treatment. RESULTS An Area Under the Curve of 0.72 was achieved using leave-one-subject-out cross-validation for remission classification and 0.75 for response to treatment. CONCLUSION This work demonstrates the potential for the classification of MDD remission and response to DBS treatment from passively acquired video captured during unstructured, unscripted psychiatric interviews. SIGNIFICANCE This novel MDD evaluation could be used to augment current psychiatric evaluations and allow automatic, low-cost, frequent use when an expert isn't readily available or the patient is unwilling or unable to engage. Potentially, the framework may also be applied to other psychiatric disorders.
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Czamara D, Tissink E, Tuhkanen J, Martins J, Awaloff Y, Drake AJ, Khulan B, Palotie A, Winter SM, Nemeroff CB, Craighead WE, Dunlop BW, Mayberg HS, Kinkead B, Mathew SJ, Iosifescu DV, Neylan TC, Heim CM, Lahti J, Eriksson JG, Räikkönen K, Ressler KJ, Provençal N, Binder EB. Combined effects of genotype and childhood adversity shape variability of DNA methylation across age. Transl Psychiatry 2021; 11:88. [PMID: 33526782 PMCID: PMC7851167 DOI: 10.1038/s41398-020-01147-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 01/04/2023] Open
Abstract
Lasting effects of adversity, such as exposure to childhood adversity (CA) on disease risk, may be embedded via epigenetic mechanisms but findings from human studies investigating the main effects of such exposure on epigenetic measures, including DNA methylation (DNAm), are inconsistent. Studies in perinatal tissues indicate that variability of DNAm at birth is best explained by the joint effects of genotype and prenatal environment. Here, we extend these analyses to postnatal stressors. We investigated the contribution of CA, cis genotype (G), and their additive (G + CA) and interactive (G × CA) effects to DNAm variability in blood or saliva from five independent cohorts with a total sample size of 1074 ranging in age from childhood to late adulthood. Of these, 541 were exposed to CA, which was assessed retrospectively using self-reports or verified through social services and registries. For the majority of sites (over 50%) in the adult cohorts, variability in DNAm was best explained by G + CA or G × CA but almost never by CA alone. Across ages and tissues, 1672 DNAm sites showed consistency of the best model in all five cohorts, with G × CA interactions explaining most variance. The consistent G × CA sites mapped to genes enriched in brain-specific transcripts and Gene Ontology terms related to development and synaptic function. Interaction of CA with genotypes showed the strongest contribution to DNAm variability, with stable effects across cohorts in functionally relevant genes. This underscores the importance of including genotype in studies investigating the impact of environmental factors on epigenetic marks.
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Affiliation(s)
- Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany.
| | - Elleke Tissink
- grid.12380.380000 0004 1754 9227Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Johanna Tuhkanen
- grid.7737.40000 0004 0410 2071Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, 00014 Helsinki, Finland
| | - Jade Martins
- grid.419548.50000 0000 9497 5095Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany
| | | | - Amanda J. Drake
- grid.4305.20000 0004 1936 7988University/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ UK
| | - Batbayar Khulan
- grid.4305.20000 0004 1936 7988University/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ UK
| | - Aarno Palotie
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland
| | - Sibylle M. Winter
- grid.6363.00000 0001 2218 4662Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Campus Virchow, 13353 Berlin, Germany
| | - Charles B. Nemeroff
- grid.89336.370000 0004 1936 9924Department of Psychiatry, Dell Medical School, University of Texas at Austin, 1601 Trinity St, Austin, TX 78712 USA
| | - W. Edward Craighead
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr, Atlanta, GA 30329 USA
| | - Boadie W. Dunlop
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr, Atlanta, GA 30329 USA
| | - Helen S. Mayberg
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr, Atlanta, GA 30329 USA ,grid.59734.3c0000 0001 0670 2351Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy PI, New York, NY 10029 USA
| | - Becky Kinkead
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr, Atlanta, GA 30329 USA
| | - Sanjay J. Mathew
- grid.413890.70000 0004 0420 5521Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine Mental Health Care Line, Michael E. Debakey VA Medical Center, Houston, TX USA
| | - Dan V. Iosifescu
- grid.59734.3c0000 0001 0670 2351Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy PI, New York, NY 10029 USA ,grid.137628.90000 0004 1936 8753NYU School of Medicine and Nathan Kline Institute, New York, NY USA
| | - Thomas C. Neylan
- grid.266102.10000 0001 2297 6811Departments of Psychiatry and Neurology, University of California, San Francisco, CA USA
| | - Christine M. Heim
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Institute of Medical Psychology, Luisenstraße 57, 10117 Berlin, Germany
| | - Jari Lahti
- grid.7737.40000 0004 0410 2071Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, 00014 Helsinki, Finland ,grid.1374.10000 0001 2097 1371Turku Institute for Advanced Studies, University of Turku, 20500 Turku, Finland
| | - Johan G. Eriksson
- grid.7737.40000 0004 0410 2071Department of General Practice and Primary Health Care, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, 00250 Helsinki, Finland ,grid.4280.e0000 0001 2180 6431Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Singapore, Singapore
| | - Katri Räikkönen
- grid.7737.40000 0004 0410 2071Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, 00014 Helsinki, Finland
| | - Kerry J. Ressler
- Mailman Research Center, 115 Mill St., Mailstop 339, Belmont, MA 02478 USA
| | - Nadine Provençal
- grid.61971.380000 0004 1936 7494Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC Canada ,grid.414137.40000 0001 0684 7788BC Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Elisabeth B. Binder
- grid.419548.50000 0000 9497 5095Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany ,grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr, Atlanta, GA 30329 USA
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Chandler JA, Cabrera LY, Doshi P, Fecteau S, Fins JJ, Guinjoan S, Hamani C, Herrera-Ferrá K, Honey CM, Illes J, Kopell BH, Lipsman N, McDonald PJ, Mayberg HS, Nadler R, Nuttin B, Oliveira-Maia AJ, Rangel C, Ribeiro R, Salles A, Wu H. International Legal Approaches to Neurosurgery for Psychiatric Disorders. Front Hum Neurosci 2021; 14:588458. [PMID: 33519399 PMCID: PMC7838635 DOI: 10.3389/fnhum.2020.588458] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/30/2020] [Indexed: 11/17/2022] Open
Abstract
Neurosurgery for psychiatric disorders (NPD), also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law (what should be regulated), what types of regulations are required (eligibility criteria, approval procedures, data collection, and oversight mechanisms), and how to approach international harmonization given the potential migration of researchers and patients.
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Affiliation(s)
| | - Laura Y. Cabrera
- Center for Ethics & Humanities in the Life Sciences and Dept. Translational Neuroscience, Michigan State University, East Lansing, MI, United States
| | - Paresh Doshi
- Department of Neurosurgery, Jaslok Hospital and Research Center, Mumbai, India
| | - Shirley Fecteau
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- CERVO Brain Research Center, Center Intégré Universitaire en Santé et Services Sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Joseph J. Fins
- Weill Cornell Medical College, Consortium for the Advanced Study of Brain Injury, Weill Cornell and the Rockefeller University, New York, NY, United States
- Solomon Center for Health Law & Policy, Yale Law School, New Haven, CT, United States
| | | | - Clement Hamani
- Harquail Center for Neuromodulation, Sunnybrook Research Institute, Division of Neurosurgery, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | | | - C. Michael Honey
- Section of Neurosurgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Brian H. Kopell
- Departments of Neurosurgery, Neurology, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nir Lipsman
- Division of Neurosurgery, Harquail Center for Neuromodulation, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Patrick J. McDonald
- Division of Neurosurgery, Faculty of Medicine, BC Children's Hospital, University of British Columbia, Head, Vancouver, BC, Canada
| | - Helen S. Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Roland Nadler
- Peter A. Allard School of Law, University of British Columbia, Vancouver, BC, Canada
| | - Bart Nuttin
- Neurosurgeon, Katholieke Universiteit (KU) Leuven, Universitair Ziekenhuis (UZ) Leuven, Leuven, Belgium
| | - Albino J. Oliveira-Maia
- Champalimaud Research and Clinical Center, Champalimaud Center for the Unknown, Lisbon, Portugal
- NOVA Medical School, NMS, Universidade Nova De Lisboa, Lisbon, Portugal
| | - Cristian Rangel
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Arleen Salles
- Center for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Hemmings Wu
- Department of Neurosurgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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45
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Tai HH, Cha J, Vedaei F, Dunlop BW, Craighead WE, Mayberg HS, Choi KS. Treatment-Specific Hippocampal Subfield Volume Changes With Antidepressant Medication or Cognitive-Behavior Therapy in Treatment-Naive Depression. Front Psychiatry 2021; 12:718539. [PMID: 35002790 PMCID: PMC8739262 DOI: 10.3389/fpsyt.2021.718539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Hippocampal atrophy has been consistently reported in major depressive disorder with more recent focus on subfields. However, literature on hippocampal volume changes after antidepressant treatment has been limited. The first-line treatments for depression include antidepressant medication (ADM) or cognitive-behavior therapy (CBT). To understand the differential effects of CBT and ADM on the hippocampus, we investigated the volume alterations of hippocampal subfields with treatment, outcome, and chronicity in treatment-naïve depression patients. Methods: Treatment-naïve depressed patients from the PReDICT study were included in this analysis. A total of 172 patients who completed 12 weeks of randomized treatment with CBT (n = 45) or ADM (n = 127) were included for hippocampal subfield volume analysis. Forty healthy controls were also included for the baseline comparison. Freesurfer 6.0 was used to segment 26 hippocampal substructures and bilateral whole hippocampus from baseline and week 12 structural MRI scans. A generalized linear model with covariates of age and gender was used for group statistical tests. A linear mixed model for the repeated measures with covariates of age and gender was used to examine volumetric changes over time and the contributing effects of treatment type, outcome, and illness chronicity. Results: Of the 172 patients, 85 achieved remission (63/127 ADM, 22/45 CBT). MDD patients showed smaller baseline volumes than healthy controls in CA1, CA3, CA4, parasubiculum, GC-ML-DG, Hippocampal Amygdala Transition Area (HATA), and fimbria. Over 12 weeks of treatment, further declines in the volumes of CA1, fimbria, subiculum, and HATA were observed regardless of treatment type or outcome. CBT remitters, but not ADM remitters, showed volume reduction in the right hippocampal tail. Unlike ADM remitters, ADM non-responders had a decline in volume in the bilateral hippocampal tails. Baseline volume of left presubiculum (regardless of treatment type) and right fimbria and HATA in CBT patients were correlated with a continuous measure of clinical improvement. Chronicity of depression had no effect on any measures of hippocampal subfield volumes. Conclusion: Two first-line antidepressant treatments, CBT and ADM, have different effects on hippocampal tail after 12 weeks. This finding suggests that remission achieved via ADM may protect against progressive hippocampal atrophy by altering neuronal plasticity or supporting neurogenesis. Studies with multimodal neuroimaging, including functional and structural analysis, are needed to assess further the impact of two different antidepressant treatments on hippocampal subfields.
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Affiliation(s)
- Hua-Hsin Tai
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jungho Cha
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Faezeh Vedaei
- Thomas Jefferson University, Philadelphia, PA, United States
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Lopez JP, Brivio E, Santambrogio A, De Donno C, Kos A, Peters M, Rost N, Czamara D, Brückl TM, Roeh S, Pöhlmann ML, Engelhardt C, Ressle A, Stoffel R, Tontsch A, Villamizar JM, Reincke M, Riester A, Sbiera S, Fassnacht M, Mayberg HS, Craighead WE, Dunlop BW, Nemeroff CB, Schmidt MV, Binder EB, Theis FJ, Beuschlein F, Andoniadou CL, Chen A. Single-cell molecular profiling of all three components of the HPA axis reveals adrenal ABCB1 as a regulator of stress adaptation. Sci Adv 2021; 7:eabe4497. [PMID: 33571131 PMCID: PMC7840126 DOI: 10.1126/sciadv.abe4497] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/09/2020] [Indexed: 05/03/2023]
Abstract
Chronic activation and dysregulation of the neuroendocrine stress response have severe physiological and psychological consequences, including the development of metabolic and stress-related psychiatric disorders. We provide the first unbiased, cell type-specific, molecular characterization of all three components of the hypothalamic-pituitary-adrenal axis, under baseline and chronic stress conditions. Among others, we identified a previously unreported subpopulation of Abcb1b+ cells involved in stress adaptation in the adrenal gland. We validated our findings in a mouse stress model, adrenal tissues from patients with Cushing's syndrome, adrenocortical cell lines, and peripheral cortisol and genotyping data from depressed patients. This extensive dataset provides a valuable resource for researchers and clinicians interested in the organism's nervous and endocrine responses to stress and the interplay between these tissues. Our findings raise the possibility that modulating ABCB1 function may be important in the development of treatment strategies for patients suffering from metabolic and stress-related psychiatric disorders.
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Affiliation(s)
- Juan Pablo Lopez
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
- The Max Planck Society-Weizmann Institute of Science Laboratory for Experimental Neuropsychiatry and Behavioral Neurogenetics, Rehovot 76100, Israel and Munich, Bavaria 80804, Germany
| | - Elena Brivio
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
- The Max Planck Society-Weizmann Institute of Science Laboratory for Experimental Neuropsychiatry and Behavioral Neurogenetics, Rehovot 76100, Israel and Munich, Bavaria 80804, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Bavaria 80804, Germany
| | - Alice Santambrogio
- Centre for Craniofacial and Regenerative Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London SE11UL, UK
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony 01307, Germany
| | - Carlo De Donno
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
- The Max Planck Society-Weizmann Institute of Science Laboratory for Experimental Neuropsychiatry and Behavioral Neurogenetics, Rehovot 76100, Israel and Munich, Bavaria 80804, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Bavaria 85764, Germany
| | - Aron Kos
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
- The Max Planck Society-Weizmann Institute of Science Laboratory for Experimental Neuropsychiatry and Behavioral Neurogenetics, Rehovot 76100, Israel and Munich, Bavaria 80804, Germany
| | - Miriam Peters
- Department for Endocrinology, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, Munich, Bavaria 80336, Germany
| | - Nicolas Rost
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Bavaria 80804, Germany
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Tanja M Brückl
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Simone Roeh
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Max L Pöhlmann
- Research Group Neurobiology of Stress Resilience, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Clara Engelhardt
- Research Group Neurobiology of Stress Resilience, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Andrea Ressle
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Rainer Stoffel
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Alina Tontsch
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Javier M Villamizar
- Department for Endocrinology, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, Munich, Bavaria 80336, Germany
| | - Martin Reincke
- Department for Endocrinology, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, Munich, Bavaria 80336, Germany
| | - Anna Riester
- Department for Endocrinology, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, Munich, Bavaria 80336, Germany
| | - Silviu Sbiera
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Bavaria 97080, Germany
| | - Martin Fassnacht
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Bavaria 97080, Germany
| | - Helen S Mayberg
- Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Charles B Nemeroff
- Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin, TX 78738, USA
| | - Mathias V Schmidt
- Research Group Neurobiology of Stress Resilience, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany
| | - Fabian J Theis
- Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Bavaria 85764, Germany
- Department of Mathematics, Technische Universität München, Munich, Bavaria 85748, Germany
| | - Felix Beuschlein
- Department for Endocrinology, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, Munich, Bavaria 80336, Germany
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zurich 8091, Switzerland
| | - Cynthia L Andoniadou
- Centre for Craniofacial and Regenerative Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London SE11UL, UK
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony 01307, Germany
| | - Alon Chen
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Bavaria 80804, Germany.
- The Max Planck Society-Weizmann Institute of Science Laboratory for Experimental Neuropsychiatry and Behavioral Neurogenetics, Rehovot 76100, Israel and Munich, Bavaria 80804, Germany
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
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Liu D, Zhuang Y, Zhang L, Gao H, Neavin D, Carrillo-Roa T, Wang Y, Yu J, Qin S, Kim DC, Liu E, Nguyen TTL, Biernacka JM, Kaddurah-Daouk R, Dunlop BW, Craighead WE, Mayberg HS, Binder EB, Frye MA, Wang L, Weinshilboum RM. ERICH3: vesicular association and antidepressant treatment response. Mol Psychiatry 2021; 26:2415-2428. [PMID: 33230203 PMCID: PMC8141066 DOI: 10.1038/s41380-020-00940-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 09/30/2020] [Accepted: 10/26/2020] [Indexed: 01/22/2023]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are standard of care for major depressive disorder (MDD) pharmacotherapy, but only approximately half of these patients remit on SSRI therapy. Our previous genome-wide association study identified a single-nucleotide polymorphism (SNP) signal across the glutamate-rich 3 (ERICH3) gene that was nearly genome-wide significantly associated with plasma serotonin (5-HT) concentrations, which were themselves associated with SSRI response for MDD patients enrolled in the Mayo Clinic PGRN-AMPS SSRI trial. In this study, we performed a meta-analysis which demonstrated that those SNPs were significantly associated with SSRI treatment outcomes in four independent MDD trials. However, the function of ERICH3 and molecular mechanism(s) by which it might be associated with plasma 5-HT concentrations and SSRI clinical response remained unclear. Therefore, we characterized the human ERICH3 gene functionally and identified ERICH3 mRNA transcripts and protein isoforms that are highly expressed in central nervous system cells. Coimmunoprecipitation identified a series of ERICH3 interacting proteins including clathrin heavy chain which are known to play a role in vesicular function. Immunofluorescence showed ERICH3 colocalization with 5-HT in vesicle-like structures, and ERICH3 knock-out dramatically decreased 5-HT staining in SK-N-SH cells as well as 5-HT concentrations in the culture media and cell lysates without changing the expression of 5-HT synthesizing or metabolizing enzymes. Finally, immunofluorescence also showed ERICH3 colocalization with dopamine in human iPSC-derived neurons. These results suggest that ERICH3 may play a significant role in vesicular function in serotonergic and other neuronal cell types, which might help explain its association with antidepressant treatment response.
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Affiliation(s)
- Duan Liu
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Yongxian Zhuang
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA ,Present Address: Rubedo Life Sciences, Sunnyvale, CA USA
| | - Lingxin Zhang
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Huanyao Gao
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Drew Neavin
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA ,grid.415306.50000 0000 9983 6924Present Address: Centre for Cellular Genomics, Garvan Institute of Medical Research, Sydney, NSW Australia
| | - Tania Carrillo-Roa
- grid.419548.50000 0000 9497 5095Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Yani Wang
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA ,grid.412262.10000 0004 1761 5538Xi’an No.1 Hospital, the First Affiliated Hospital of Northwest University, Xi’an, Shaanxi China ,Shaanxi Institute of Ophthalmology, Shaanxi Key Laboratory of Ophthalmology, Shaanxi Clinical Research Center for Ophthalmology Diseases, Xi’an, Shaanxi China
| | - Jia Yu
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Sisi Qin
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Daniel C. Kim
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Erica Liu
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Thanh Thanh Le Nguyen
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Joanna M. Biernacka
- grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN USA ,grid.66875.3a0000 0004 0459 167XDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN USA
| | - Rima Kaddurah-Daouk
- grid.26009.3d0000 0004 1936 7961Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Institute for Brain Sciences, Duke University, Durham, NC USA
| | - Boadie W. Dunlop
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - W. Edward Craighead
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Helen S. Mayberg
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA ,grid.59734.3c0000 0001 0670 2351Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Elisabeth B. Binder
- grid.419548.50000 0000 9497 5095Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany ,grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Mark A. Frye
- grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN USA
| | - Liewei Wang
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
| | - Richard M. Weinshilboum
- grid.66875.3a0000 0004 0459 167XDivision of Clinical Pharmacology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN USA
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Smith AH, Choi KS, Waters AC, Aloysi A, Mayberg HS, Kopell BH, Figee M. Replicable effects of deep brain stimulation for obsessive-compulsive disorder. Brain Stimul 2020; 14:1-3. [PMID: 33130018 DOI: 10.1016/j.brs.2020.10.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 01/06/2023] Open
Affiliation(s)
- Andrew H Smith
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY, United States
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY, United States
| | - Allison C Waters
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY, United States
| | - Amy Aloysi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY, United States
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY, United States
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY, United States
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, NY, United States.
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49
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Riva-Posse P, Crowell AL, Wright K, Waters AC, Choi K, Garlow SJ, Holtzheimer PE, Gross RE, Mayberg HS. Rapid Antidepressant Effects of Deep Brain Stimulation and Their Relation to Surgical Protocol. Biol Psychiatry 2020; 88:e37-e39. [PMID: 32418613 PMCID: PMC9826729 DOI: 10.1016/j.biopsych.2020.03.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 01/11/2023]
Affiliation(s)
- Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
| | - Andrea L. Crowell
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Kathryn Wright
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Allison C. Waters
- Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - KiSueng Choi
- Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Steven J. Garlow
- Department of Psychiatry, University of Wisconsin, Madison, Wisconsin
| | - Paul E. Holtzheimer
- Departments of Psychiatry and Surgery, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Robert E. Gross
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Helen S. Mayberg
- Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
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50
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McCall MV, Riva-Posse P, Garlow SJ, Mayberg HS, Crowell AL. Analyzing Non-verbal Behavior Throughout Recovery in a Sample of Depressed Patients Receiving Deep Brain Stimulation. Neurol Psychiatry Brain Res 2020; 37:33-40. [PMID: 32699489 PMCID: PMC7375407 DOI: 10.1016/j.npbr.2020.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Traditional rating scales for depression rely heavily on patient self-report, and lack detailed measurement of non-verbal behavior. However, there is evidence that depression is associated with distinct non-verbal behaviors, assessment of which may provide useful information about recovery. This study examines non-verbal behavior in a sample of patients receiving Deep Brain Stimulation (DBS) treatment of depression, with the purpose to investigate the relationship between non-verbal behaviors and reported symptom severity. METHODS Videotaped clinical interviews of twelve patients participating in a study of DBS for treatment-resistant depression were analyzed at three time points (before treatment and after 3 months and 6 months of treatment), using an ethogram to assess the frequencies of 42 non-verbal behaviors. The Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS-17) were also collected at all time points. RESULTS Factor analysis grouped non-verbal behaviors into three factors: react, engage/fidget, and disengage. Two-way repeated measures ANOVA showed that scores on the three factors change differently from each other over time. Mixed effects modelling assessed the relationship between BDI score and frequency of non-verbal behaviors, and provided evidence that the frequency of behaviors related to reactivity and engagement increase as BDI score decreases. LIMITATIONS This study assesses a narrow sample of patients with a distinct clinical profile at limited time points. CONCLUSIONS Non-verbal behavior provides information about clinical states and may be reliably quantified using ethograms. Non-verbal behavior may provide distinct information compared to self-report.
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Affiliation(s)
- Micaela V. McCall
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Patricio Riva-Posse
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | | | - Helen S. Mayberg
- Icahn School of Medicine at Mount Sinai, Center for Advanced Circuit Therapeutics
| | - Andrea L. Crowell
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences
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