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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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2
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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 2024; 29:112-120. [PMID: 37919403 PMCID: PMC11078711 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] [Key Words] [MESH Headings] [Grants] [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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3
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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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4
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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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6
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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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7
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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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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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Cha J, Rajendra JJ, McGrath C, Riva-Posse P, Holtzheimer P, Mayberg H, Choi KS. Whole Brain Network effects of subcallosal cingulate deep brain stimulation for treatment-resistant depression. Res Sq 2023:rs.3.rs-3025802. [PMID: 37398243 PMCID: PMC10312967 DOI: 10.21203/rs.3.rs-3025802/v1] [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: 07/04/2023]
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 ow (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 [15O]-water and 5 [18]-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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10
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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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Verma G, Choi KS, Mayberg H, Balchandani P. Differential patterns of automatic segmentation of 3T and 7T MRI: Implications in neuropsychiatric disease. bioRxiv 2023:2023.01.25.525542. [PMID: 36747735 PMCID: PMC9900842 DOI: 10.1101/2023.01.25.525542] [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: 01/30/2023]
Abstract
Automatic segmentation was performed on T1-MPRAGE structural MRI data acquired at 3T and 7T from 37 and 69 distinct healthy controls, respectively. Additionally, segmentation was performed on imaging acquired from 215 major depressive disorder (MDD) patients at 3T and 40 MDD patients at 7T. Of 259 segmentation-derived imaging features evaluated, 120 showed significant 3T vs. 7T differences among controls, and 153 among patients. 7T imaging metrics showed consistently lower cortical thickness and cortical gray/white matter ratios. Subcortical and cortical volumes measured at 7T were more mixed, with 7T images showing greater frontal lobe volume, but lower cortical volumes elsewhere.
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12
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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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13
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Song HN, Elias G, Germann J, Boutet A, Lozano A, Mayberg H, Choi KS. Tractography analysis of subcallosal cingulate DBS for treatment-resistant depression using normative connectome data. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.782] [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: 02/17/2023] Open
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14
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Choi KS, Figee M, Riva-posse P, Kopell B, Mayberg H. Personalised targeting of brain circuits using diffusion tractography in DBS. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.184] [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: 02/17/2023] Open
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15
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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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16
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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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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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18
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Cha J, Choi KS, Khang J, Figee M, Posse PR, Kopell B, Mayberg H. ID:16557 Longitudinal Changes in Default Mode Network With Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Depression. Neuromodulation 2022. [DOI: 10.1016/j.neurom.2022.02.120] [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: 11/16/2022]
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19
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DiRisio A, Avecillas-Chasin JM, Platt S, Figee M, Jimenez-Shahed J, Mayber,g HS, Choi KS, Kopell BH. 819 White Matter Activation Pathways in STN and GPi DBS for Parkinson’s Disease. Neurosurgery 2022. [DOI: 10.1227/neu.0000000000001880_819] [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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20
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Tiruvadi V, Choi KS, Gross RE, Butera R, Jirsa V, Mayberg H. Dynamic Oscillations Evoked by Subcallosal Cingulate Deep Brain Stimulation. Front Neurosci 2022; 16:768355. [PMID: 35281513 PMCID: PMC8905359 DOI: 10.3389/fnins.2022.768355] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Deep brain stimulation (DBS) of subcallosal cingulate white matter (SCCwm) alleviates symptoms of depression, but its mechanistic effects on brain dynamics remain unclear. In this study we used novel intracranial recordings (LFP) in n = 6 depressed patients stimulated with DBS around the SCCwm target, observing a novel dynamic oscillation (DOs). We confirm that DOs in the LFP are of neural origin and consistently evoked within certain patients. We then characterize the frequency and dynamics of DOs, observing significant variability in DO behavior across patients. Under the hypothesis that LFP-DOs reflect network engagement, we characterize the white matter tracts associated with LFP-DO observations and report a preliminary observation of DO-like activity measured in a single patient's electroencephalography (dEEG). These results support further study of DOs as an objective signal for mechanistic study and connectomics guided DBS.
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Affiliation(s)
- Vineet Tiruvadi
- Emory School of Medicine, Emory University, Atlanta, GA, United States
- Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, GA, United States
- School of Electrical and Computer Engineering, Georgia Tech, Atlanta, GA, United States
| | - Ki Sueng Choi
- Icahn School of Medicine, Mount Sinai, New York, NY, United States
| | - Robert E. Gross
- Emory School of Medicine, Emory University, Atlanta, GA, United States
- Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, GA, United States
| | - Robert Butera
- Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, GA, United States
- School of Electrical and Computer Engineering, Georgia Tech, Atlanta, GA, United States
| | - Viktor Jirsa
- Institut de Neurosciences des Systèmes, Aix-Marseille Université, Marseille, France
| | - Helen Mayberg
- Icahn School of Medicine, Mount Sinai, New York, NY, United States
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21
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Howell B, Waters A, Choi KS, Noor MS, Seas A, Obatusin M, Veerakumar A, Dahill-Fuchel J, McIntyre C, Mayberg H. Guiding individual tract activations in the subcallosal cingulate region using image-based biophysical modeling. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.522] [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: 11/17/2022] Open
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22
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Choi KS, Riva-Posse P, Figee M, Mayberg H. Connectome DBS for psychiatric disorders. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.491] [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: 11/30/2022] Open
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23
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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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24
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Sui Y, Tian Y, Ko WKD, Wang Z, Jia F, Horn A, De Ridder D, Choi KS, Bari AA, Wang S, Hamani C, Baker KB, Machado AG, Aziz TZ, Fonoff ET, Kühn AA, Bergman H, Sanger T, Liu H, Haber SN, Li L. Deep Brain Stimulation Initiative: Toward Innovative Technology, New Disease Indications, and Approaches to Current and Future Clinical Challenges in Neuromodulation Therapy. Front Neurol 2021; 11:597451. [PMID: 33584498 PMCID: PMC7876228 DOI: 10.3389/fneur.2020.597451] [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: 08/21/2020] [Accepted: 11/23/2020] [Indexed: 01/17/2023] Open
Abstract
Deep brain stimulation (DBS) is one of the most important clinical therapies for neurological disorders. DBS also has great potential to become a great tool for clinical neuroscience research. Recently, the National Engineering Laboratory for Neuromodulation at Tsinghua University held an international Deep Brain Stimulation Initiative workshop to discuss the cutting-edge technological achievements and clinical applications of DBS. We specifically addressed new clinical approaches and challenges in DBS for movement disorders (Parkinson's disease and dystonia), clinical application toward neurorehabilitation for stroke, and the progress and challenges toward DBS for neuropsychiatric disorders. This review highlighted key developments in (1) neuroimaging, with advancements in 3-Tesla magnetic resonance imaging DBS compatibility for exploration of brain network mechanisms; (2) novel DBS recording capabilities for uncovering disease pathophysiology; and (3) overcoming global healthcare burdens with online-based DBS programming technology for connecting patient communities. The successful event marks a milestone for global collaborative opportunities in clinical development of neuromodulation to treat major neurological disorders.
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Affiliation(s)
- Yanan Sui
- National Engineering Laboratory for Neuromodulation, Tsinghua University, Beijing, China
| | - Ye Tian
- National Engineering Laboratory for Neuromodulation, Tsinghua University, Beijing, China
| | - Wai Kin Daniel Ko
- National Engineering Laboratory for Neuromodulation, Tsinghua University, Beijing, China
| | - Zhiyan Wang
- National Engineering Laboratory for Neuromodulation, Tsinghua University, Beijing, China
| | - Fumin Jia
- National Engineering Laboratory for Neuromodulation, Tsinghua University, Beijing, China
| | - Andreas Horn
- Charité, Department of Neurology, Movement Disorders and Neuromodulation Unit, University Medicine Berlin, Berlin, Germany
| | - Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioural Science, Emory University, Atlanta, GA, United States.,Department of Radiology, Mount Sinai School of Medicine, New York, NY, United States.,Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, United States
| | - Ausaf A Bari
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shouyan Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Clement Hamani
- Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Kenneth B Baker
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.,Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Andre G Machado
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.,Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Tipu Z Aziz
- Department of Neurosurgery, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Erich Talamoni Fonoff
- Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.,Hospital Sírio-Libanês and Hospital Albert Einstein, São Paulo, Brazil
| | - Andrea A Kühn
- Charité, Department of Neurology, Movement Disorders and Neuromodulation Unit, University Medicine Berlin, Berlin, Germany
| | - Hagai Bergman
- Department of Medical Neurobiology (Physiology), Institute of Medical Research-Israel-Canada (IMRIC), Faculty of Medicine, Jerusalem, Israel.,The Edmond and Lily Safra Center for Brain Research (ELSC), The Hebrew University and Department of Neurosurgery, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Terence Sanger
- University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Hesheng Liu
- Department of Neuroscience, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Suzanne N Haber
- Department of Pharmacology and Physiology, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States.,McLean Hospital and Harvard Medical School, Belmont, MA, United States
| | - Luming Li
- National Engineering Laboratory for Neuromodulation, Tsinghua University, Beijing, China
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25
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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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26
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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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Higgins IA, Kundu S, Choi KS, Mayberg HS, Guo Y. A difference degree test for comparing brain networks. Hum Brain Mapp 2019; 40:4518-4536. [PMID: 31350786 PMCID: PMC6865740 DOI: 10.1002/hbm.24718] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 01/18/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 11/10/2022] Open
Abstract
Recently, there has been a proliferation of methods investigating functional connectivity as a biomarker for mental disorders. Typical approaches include massive univariate testing at each edge or comparisons of network metrics to identify differing topological features. Limitations of these methods include low statistical power due to the large number of comparisons and difficulty attributing overall differences in networks to local variation. We propose a method to capture the difference degree, which is the number of edges incident to each region in the difference network. Our difference degree test (DDT) is a two-step procedure for identifying brain regions incident to a significant number of differentially weighted edges (DWEs). First, we select a data-adaptive threshold which identifies the DWEs followed by a statistical test for the number of DWEs incident to each brain region. We achieve this by generating an appropriate set of null networks which are matched on the first and second moments of the observed difference network using the Hirschberger-Qi-Steuer algorithm. This formulation permits separation of the network's true topology from the nuisance topology induced by the correlation measure that alters interregional connectivity in ways unrelated to brain function. In simulations, the proposed approach outperforms competing methods in detecting differentially connected regions of interest. Application of DDT to a major depressive disorder dataset leads to the identification of brain regions in the default mode network commonly implicated in this ruminative disorder.
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Affiliation(s)
- Ixavier A. Higgins
- Department of Biostatistics and BioinformaticsRollins School of Public Health, Emory UniversityAtlantaGeorgia
| | - Suprateek Kundu
- Department of Biostatistics and BioinformaticsRollins School of Public Health, Emory UniversityAtlantaGeorgia
| | - Ki Sueng Choi
- Department of Psychiatry and NeurologyEmory University School of MedicineAtlantaGeorgia
| | - Helen S. Mayberg
- Department of Psychiatry and NeurologyEmory University School of MedicineAtlantaGeorgia
| | - Ying Guo
- Department of Biostatistics and BioinformaticsRollins School of Public Health, Emory UniversityAtlantaGeorgia
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Veerakumar A, Tiruvadi V, Howell B, Waters AC, Crowell AL, Voytek B, Riva-Posse P, Denison L, Rajendra JK, Edwards JA, Bijanki KR, Choi KS, Mayberg HS. Field potential 1/ f activity in the subcallosal cingulate region as a candidate signal for monitoring deep brain stimulation for treatment-resistant depression. J Neurophysiol 2019; 122:1023-1035. [PMID: 31314668 PMCID: PMC6766743 DOI: 10.1152/jn.00875.2018] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [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: 12/31/2018] [Revised: 07/02/2019] [Accepted: 07/02/2019] [Indexed: 01/22/2023] Open
Abstract
Subcallosal cingulate cortex deep brain stimulation (SCC-DBS) is an experimental therapy for treatment-resistant depression (TRD). Refinement and optimization of SCC-DBS will benefit from increased study of SCC electrophysiology in context of ongoing high-frequency SCC-DBS therapy. The study objective was a 7-mo observation of frequency-domain 1/f slope in off-stimulation local field potentials (SCC-LFPs) alongside standardized measurements of depression severity in 4 patients undergoing SCC-DBS. SCC was implanted bilaterally with a combined neurostimulation-LFP recording system. Following a 1-mo off-stimulation postoperative phase with multiple daily recordings, patients received bilateral SCC-DBS therapy (130 Hz, 90 μs) and weekly resting-state SCC-LFP recordings over a 6-mo treatment phase. 1/f slopes for each time point were estimated via linear regression of log-transformed Welch periodograms. General linear mixed-effects models were constructed to estimate pretreatment sources of 1/f slope variance, and 95% bootstrap confidence intervals were constructed to estimate treatment phase 1/f slope association with treatment response (50% decrease in preimplantation symptom severity). Results show the time of recording was a prominent source of pretreatment 1/f slope variance bilaterally, with increased 1/f slope magnitude observed during night hours (2300-0659). Increase in right 1/f slope was observed in the setting of treatment response, with bootstrap analysis supporting this observation in 3 of 4 subjects. We conclude that 1/f slope can be measured longitudinally in a combined SCC-DBS/LFP recording system and likely conforms to known 1/f circadian variability. The preliminary evidence of 1/f slope increase during treatment response suggests a potential utility as a candidate biomarker for ongoing development of adaptive TRD-neuromodulation strategies.NEW & NOTEWORTHY In four patients with treatment-resistant depression undergoing therapeutic deep brain stimulation (DBS), we present the first longitudinal observations of local field potentials (LFP) from the subcallosal cingulate region outside the postoperative period. Specifically, our results demonstrate that frequency-domain 1/f activity is measurable in a combined DBS-LFP recording system and that right hemisphere recordings appear sensitive to mood state, thus suggesting a potential readout suitable for consideration in ongoing efforts to develop adaptive DBS delivery systems.
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Affiliation(s)
- Ashan Veerakumar
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Vineet Tiruvadi
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Bryan Howell
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Allison C Waters
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrea L Crowell
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Bradley Voytek
- Department of Cognitive Science, University of California San Diego, La Jolla, California
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Lydia Denison
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Justin K Rajendra
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Scientific and Statistical Computational Core. National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Johnathan A Edwards
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Department of Biomedical Informatics, Emory University, Atlanta, Georgia
| | - Kelly R Bijanki
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Department of Neurosurgery, Emory University, Atlanta, Georgia
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
- Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
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Benitez A, Torralba K, Ngo M, Salto LM, Choi KS, De Vera ME, Payne KJ. Belimumab alters transitional B-cell subset proportions in patients with stable systemic lupus erythematosus. Lupus 2019; 28:1337-1343. [PMID: 31423896 DOI: 10.1177/0961203319869468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE We evaluated the effects of the B-cell activating factor (BAFF)-targeting antibody Belimumab on human nonmemory B-cell pools. Human B-cell pools were identified using surface markers adapted from mouse studies that specifically assessed reductions in immature B cells due to BAFF depletion. Patients with systemic lupus erythematosus (SLE) have high levels of both BAFF and immature B cells. Mechanistic mouse studies provide a framework for understanding human responses to therapies that target B cells. METHODS Peripheral blood mononuclear cells were isolated from healthy donors and SLE patients on Belimumab or standard-of-care therapy (SCT). Cells were stained for flow cytometry to identify B-cell subsets based on CD21/CD24. Differences in subset proportions were determined by one-way ANOVA and Tukey's post hoc test. RESULTS Patients treated with Belimumab show alterations in the nonmemory B-cell pool characterized by a decrease in the Transitional 2 (T2) subset (p = 0.002), and an increase in the proportion of Transitional 1 (T1) cells (p = 0.005) as compared with healthy donors and SCT patients. The naïve B-cell compartment showed no significant differences between the groups (p = 0.293). CONCLUSION Using a translational approach, we show that Belimumab-mediated BAFF depletion reduces the T2 subset in patients, similar to observations in mouse models with BAFF depletion.
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Affiliation(s)
- A Benitez
- Transplantation Institute of Loma Linda University, Loma Linda, CA, USA.,Rheumatology Division of Loma Linda University, Loma Linda, CA, USA
| | - K Torralba
- Rheumatology Division of Loma Linda University, Loma Linda, CA, USA
| | - M Ngo
- Rheumatology Division of Loma Linda University, Loma Linda, CA, USA
| | - L M Salto
- Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA, USA
| | - K S Choi
- Rheumatology Division of Loma Linda University, Loma Linda, CA, USA
| | - M E De Vera
- Transplantation Institute of Loma Linda University, Loma Linda, CA, USA
| | - K J Payne
- Rheumatology Division of Loma Linda University, Loma Linda, CA, USA.,Department of Basic Sciences, School of Medicine, Loma Linda, CA, USA.,Department of Pathology and Human Anatomy, Loma Linda, CA, USA.,Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA, USA
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Riva-Posse P, Inman CS, Choi KS, Crowell AL, Gross RE, Hamann S, Mayberg HS. Autonomic arousal elicited by subcallosal cingulate stimulation is explained by white matter connectivity. Brain Stimul 2019; 12:743-751. [DOI: 10.1016/j.brs.2019.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 12/11/2018] [Accepted: 01/22/2019] [Indexed: 12/30/2022] Open
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31
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Del Toro FJ, Choi KS, Rakhshandehroo F, Aguilar E, Tenllado F, Canto T. Ambient conditions of elevated temperature and CO 2 levels are detrimental to the probabilities of transmission by insects of a Potato virus Y isolate and to its simulated prevalence in the environment. Virology 2019; 530:1-10. [PMID: 30753975 DOI: 10.1016/j.virol.2019.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 12/05/2018] [Revised: 01/29/2019] [Accepted: 02/03/2019] [Indexed: 12/17/2022]
Abstract
Conditions of elevated temperature and CO2 levels [30 °C and 970 parts-per-million (ppm), respectively] reduced the systemic titers of a potato virus Y (PVY) isolate in Nicotiana benthamiana plants, relative to standard conditions (25 °C, ~405 ppm CO2). Under controlled conditions we studied how these growing environments affected the transmission of infection by aphids. Probabilities of transmission of infection by insects that fed on infected donor plants kept at either standard conditions, or at 30 °C and 970 ppm CO2 were both determined and found to positively correlate with titers in donor leaves, independently of the ambient conditions in which recipient plantlets would grow. With these data, viral prevalence was simulated under conditions of elevated temperature and CO2 levels and found that for it to remain comparable to that simulated under standard conditions, insect arrivals to recipient plants in the former scenario would have to increase several-fold in their frequency.
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Affiliation(s)
- F J Del Toro
- Department of Microbial and Plant Biotechnology, Center for Biological Research, CIB-CSIC, Ramiro de Maeztu 9, Madrid 28040, Spain.
| | - K S Choi
- Research Institute for Climate Change and Agriculture, National Institute of Horticultural and Herbal Science, RDA, Jeju 690-150, Republic of Korea
| | - F Rakhshandehroo
- Department of Plant Protection, College of Agricultural Sciences and Food Technologies, Science and Research Branch, Islamic Azad University, P. O. Box 14515-775, Tehran, Iran
| | - E Aguilar
- Department of Microbial and Plant Biotechnology, Center for Biological Research, CIB-CSIC, Ramiro de Maeztu 9, Madrid 28040, Spain
| | - F Tenllado
- Department of Microbial and Plant Biotechnology, Center for Biological Research, CIB-CSIC, Ramiro de Maeztu 9, Madrid 28040, Spain
| | - T Canto
- Department of Microbial and Plant Biotechnology, Center for Biological Research, CIB-CSIC, Ramiro de Maeztu 9, Madrid 28040, Spain.
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32
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Howell B, Choi KS, Gunalan K, Rajendra J, Mayberg HS, McIntyre CC. Cover Image. Hum Brain Mapp 2019. [DOI: 10.1002/hbm.24254] [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: 11/07/2022] Open
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33
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Bijanki KR, Manns JR, Inman CS, Choi KS, Harati S, Pedersen NP, Drane DL, Waters AC, Fasano RE, Mayberg HS, Willie JT. Cingulum stimulation enhances positive affect and anxiolysis to facilitate awake craniotomy. J Clin Invest 2019; 129:1152-1166. [PMID: 30589643 DOI: 10.1172/jci120110] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 01/22/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Awake neurosurgery requires patients to converse and respond to visual or verbal prompts to identify and protect brain tissue supporting essential functions such as language, primary sensory modalities, and motor function. These procedures can be poorly tolerated because of patient anxiety, yet acute anxiolytic medications typically cause sedation and impair cortical function. METHODS In this study, direct electrical stimulation of the left dorsal anterior cingulum bundle was discovered to reliably evoke positive affect and anxiolysis without sedation in a patient with epilepsy undergoing research testing during standard inpatient intracranial electrode monitoring. These effects were quantified using subjective and objective behavioral measures, and stimulation was found to evoke robust changes in local and distant neural activity. RESULTS The index patient ultimately required an awake craniotomy procedure to confirm safe resection margins in the treatment of her epilepsy. During the procedure, cingulum bundle stimulation enhanced positive affect and reduced the patient's anxiety to the point that intravenous anesthetic/anxiolytic medications were discontinued and cognitive testing was completed. Behavioral responses were subsequently replicated in 2 patients with anatomically similar electrode placements localized to an approximately 1-cm span along the anterior dorsal cingulum bundle above genu of the corpus callosum. CONCLUSIONS The current study demonstrates a robust anxiolytic response to cingulum bundle stimulation in 3 patients with epilepsy. TRIAL REGISTRATION The current study was not affiliated with any formal clinical trial. FUNDING This project was supported by the American Foundation for Suicide Prevention and the NIH.
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Affiliation(s)
- Kelly R Bijanki
- Department of Neurosurgery, and.,Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Joseph R Manns
- Department of Psychology, Emory University College of Arts and Sciences, Atlanta, Georgia, USA
| | | | - Ki Sueng Choi
- Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Nigel P Pedersen
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Allison C Waters
- Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rebecca E Fasano
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Helen S Mayberg
- Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jon T Willie
- Department of Neurosurgery, and.,Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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Howell B, Choi KS, Gunalan K, Rajendra J, Mayberg HS, McIntyre CC. Quantifying the axonal pathways directly stimulated in therapeutic subcallosal cingulate deep brain stimulation. Hum Brain Mapp 2018; 40:889-903. [PMID: 30311317 DOI: 10.1002/hbm.24419] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 03/26/2018] [Revised: 08/21/2018] [Accepted: 10/01/2018] [Indexed: 12/20/2022] Open
Abstract
Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an emerging experimental therapy for treatment-resistant depression. New developments in SCC DBS surgical targeting are focused on identifying specific axonal pathways for stimulation that are estimated from patient-specific computational models. This connectomic-based biophysical modeling strategy has proven successful in improving the clinical response to SCC DBS therapy, but the DBS models used to date have been relatively simplistic, limiting the precision of the pathway activation estimates. Therefore, we used the most detailed patient-specific foundation for DBS modeling currently available (i.e., field-cable modeling) to evaluate SCC DBS in our most recent cohort of six subjects, all of which were responders to the therapy. We quantified activation of four major pathways in the SCC region: forceps minor (FM), cingulum bundle (CB), uncinate fasciculus (UF), and subcortical connections between the frontal pole and the thalamus or ventral striatum (FP). We then used the percentage of activated axons in each pathway as regressors in a linear model to predict the time it took patients to reach a stable response, or TSR. Our analysis suggests that stimulation of the left and right CBs, as well as FM are the most likely therapeutic targets for SCC DBS. In addition, the right CB alone predicted 84% of the variation in the TSR, and the correlation was positive, suggesting that activation of the right CB beyond a critical percentage may actually protract the recovery process.
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Affiliation(s)
- Bryan Howell
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio.,Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia.,Department of Radiology, Mount Sinai School of Medicine, New York, New York.,Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York
| | - Kabilar Gunalan
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Justin Rajendra
- Scientific and Statistical Computational Core, National Institute of Mental Health, Bethesda, Maryland
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia.,Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York.,Department of Neurology, Mount Sinai School of Medicine, New York, New York.,Department of Psychiatry, Mount Sinai School of Medicine, New York, New York
| | - Cameron C McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
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35
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Waters AC, Veerakumar A, Choi KS, Howell B, Tiruvadi V, Bijanki KR, Crowell A, Riva-Posse P, Mayberg HS. Test-retest reliability of a stimulation-locked evoked response to deep brain stimulation in subcallosal cingulate for treatment resistant depression. Hum Brain Mapp 2018; 39:4844-4856. [PMID: 30120851 DOI: 10.1002/hbm.24327] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 06/26/2018] [Accepted: 07/12/2018] [Indexed: 12/20/2022] Open
Abstract
Deep brain stimulation (DBS) to the subcallosal cingulate cortex (SCC) is an emerging therapy for treatment resistant depression. Precision targeting of specific white matter fibers is now central to the model of SCC DBS treatment efficacy. A method to confirm SCC DBS target engagement is needed to reduce procedural variance across treatment providers and to optimize DBS parameters for individual patients. We examined the reliability of a novel cortical evoked response that is time-locked to a 2 Hz DBS pulse and shows the propagation of signal from the DBS target. The evoked response was detected in four individuals as a stereotyped series of components within 150 ms of a 6 V DBS pulse, each showing coherent topography on the head surface. Test-retest reliability across four repeated measures over 14 months met or exceeded standards for valid test construction in three of four patients. Several observations in this pilot sample demonstrate the prospective utility of this method to confirm surgical target engagement and instruct parameter selection. The topography of an orbital frontal component on the head surface showed specificity for patterns of forceps minor activation, which may provide a means to confirm DBS location with respect to key white matter structures. A divergent cortical response to unilateral stimulation of left (vs. right) hemisphere underscores the need for feedback acuity on the level of a single electrode, despite bilateral presentation of therapeutic stimulation. Results demonstrate viability of this method to explore patient-specific cortical responsivity to DBS for brain-circuit pathologies.
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Affiliation(s)
- Allison C Waters
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.,Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ashan Veerakumar
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.,Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Bryan Howell
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Vineet Tiruvadi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Kelly R Bijanki
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.,Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Andrea Crowell
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.,Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
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Jeon WJ, Lee HJ, Roh IS, Yoon YS, Kim JH, Choi KS. Effect of maternally derived antibody on sequential infection with highly virulent bursal disease virus in newly hatched broilers. Poult Sci 2018; 96:4193-4199. [PMID: 29053823 DOI: 10.3382/ps/pex230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/03/2017] [Accepted: 08/08/2017] [Indexed: 11/20/2022] Open
Abstract
Maternally derived antibodies (MDAs) are important for protection against very virulent infectious bursal disease virus (vvIBDV). In this study, 5-day-old commercial broilers with non-uniform MDA titers (with a coefficient of variation of 50%) were challenged with vvIBDV and given free contact with each other during a 2-week period. The chicks were assigned to four MDA-titer subgroups, GI-1 (very low MDA), GI-2 (low MDA), GI-3 (medium MDA), and GI-4 (high MDA). Transient symptoms of infection were observed in 35.7% of challenged birds. Body weight gain was significantly lower in GI-2, GI-3, and GI-4 birds than in an unchallenged control group. Seroconversion was observed in GI-1 birds and some GI-2 birds. The frequency of virus shedding via the cloaca in vvIBDV-challenged birds increased from 7.1% of GI birds at 5 days post inoculation (dpi) to 35.7% at 14 dpi. The timing of virus shedding was progressively later from GI-1 to GI-4. At 14 dpi, significant atrophy of the bursa of Fabricius (BF) was observed in GI birds compared with GII controls; atrophy was most severe in GI-1 birds and least severe in GI-4 birds. BF lesion scores decreased from GI-1 to GI-4. The proportion of birds with IBDV antigen in the BF at 14 dpi was higher in GI-2 and GI-3 than in GI-1 and GI-4, whereas the viral load in positive birds increased from GI-1 to GI-4. Our results indicate that high levels of MDAs would protect chicks from initial vvIBDV infection but that progressive decay of these MDAs would result in delayed infection by virus shedding in initially infected birds with low MDA titers, resulting in continuous circulation of the virus in a flock with non-uniform MDA titers.
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Affiliation(s)
- W J Jeon
- Center for Food & Drug Analysis, Gyeongin Regional Office, Ministry of Food and Drug Safety, Incheon 22133, Republic of Korea
| | - H J Lee
- Avian Disease Research Division, Animal and Plant Quarantine Agency, Gimcheon 39660, Republic of Korea
| | - I S Roh
- Foreign Animal Disease Research Division, Animal and Plant Quarantine Agency, Gimcheon 39660, Republic of Korea
| | - Y S Yoon
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - J H Kim
- Laboratory of Avian Diseases and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - K S Choi
- Avian Disease Research Division, Animal and Plant Quarantine Agency, Gimcheon 39660, Republic of Korea
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Khanh NP, Tan SW, Yeap SK, Lee HJ, Choi KS, Hair-Bejo M, Bich TN, Omar AR. Comparative Pathogenicity of Malaysian QX-like and Variant Infectious Bronchitis Virus Strains in Chickens at Different Age of Exposure to the Viruses. J Comp Pathol 2018; 161:43-54. [PMID: 30173857 DOI: 10.1016/j.jcpa.2018.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 01/24/2018] [Revised: 04/20/2018] [Accepted: 04/30/2018] [Indexed: 02/05/2023]
Abstract
Infectious bronchitis viruses (IBVs) circulating in Malaysia are classified into two groups as Malaysian QX-like and variant strains. In this study, the pathogenicity of IBS130/2015 (QX-like) and IBS037A/2014 (variant) IBVs in 1-day-old and 30-day-old specific pathogen free (SPF) chickens was characterized. Both strains caused respiratory and kidney infections based on immunohistochemistry (IHC), real-time quantitative polymerase chain reaction (qPCR) and a ciliostasis study; however, the results showed that the QX-like strain was more pathogenic, caused higher mortality and showed higher tissue tropism for the kidney than the variant strain. In contrast, despite causing low or no mortality depending on the age of the infected chickens, the Malaysian variant strain showed high tissue tropism for the respiratory tract compared with the QX-like strain. IHC and qPCR indicated the presence of both IBV strains in the epithelial lining of villi in the jejunum and the caecal tonsil; however, no pathological changes were detected in these organs. Both the Malaysian QX-like and variant IBV strains are able to infect the respiratory tract and kidney of chickens irrespective of age.
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Affiliation(s)
- N P Khanh
- Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Faculty of Agriculture and Applied Biology, Can Tho University, Xuan Khanh, Ninh Kieu, Can Tho, Viet Nam
| | - S W Tan
- Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - S K Yeap
- Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - H J Lee
- Avian Disease Division, 177 Hyeoksin 8-ro, Gimcheon-si, Gyeongsangbuk-do, Republic of Korea
| | - K S Choi
- Avian Disease Division, 177 Hyeoksin 8-ro, Gimcheon-si, Gyeongsangbuk-do, Republic of Korea
| | - M Hair-Bejo
- Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - T N Bich
- Faculty of Agriculture and Applied Biology, Can Tho University, Xuan Khanh, Ninh Kieu, Can Tho, Viet Nam
| | - A R Omar
- Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
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Choi KS, Noecker AM, Riva-Posse P, Rajendra JK, Gross RE, Mayberg HS, McIntyre CC. Impact of brain shift on subcallosal cingulate deep brain stimulation. Brain Stimul 2017; 11:445-453. [PMID: 29246748 DOI: 10.1016/j.brs.2017.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 08/14/2017] [Revised: 11/27/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an emerging experimental therapy for treatment-resistant depression. New developments in SCC DBS surgical targeting are focused on identifying specific axonal pathways for stimulation that are estimated from preoperatively collected diffusion-weighted imaging (DWI) data. However, brain shift induced by opening burr holes in the skull may alter the position of the target pathways. OBJECTIVES Quantify the effect of electrode location deviations on tractographic representations for stimulating the target pathways using longitudinal clinical imaging datasets. METHODS Preoperative MRI and DWI data (planned) were coregistered with postoperative MRI (1 day, near-term) and CT (3 weeks, long-term) data. Brain shift was measured with anatomical control points. Electrode models corresponding to the planned, near-term, and long-term locations were defined in each hemisphere of 15 patients. Tractography analyses were performed using estimated stimulation volumes as seeds centered on the different electrode positions. RESULTS Mean brain shift of 2.2 mm was observed in the near-term for the frontal pole, which resolved in the long-term. However, electrode displacements from the planned stereotactic target location were observed in the anterior-superior direction in both the near-term (mean left electrode shift: 0.43 mm, mean right electrode shift: 0.99 mm) and long-term (mean left electrode shift: 1.02 mm, mean right electrode shift: 1.47 mm). DBS electrodes implanted in the right hemisphere (second-side operated) were more displaced from the plan than those in the left hemisphere. These displacements resulted in 3.6% decrease in pathway activation between the electrode and the ventral striatum, but 2.7% increase in the frontal pole connection, compared to the plan. Remitters from six-month chronic stimulation had less variance in pathway activation patterns than the non-remitters. CONCLUSIONS Brain shift is an important concern for SCC DBS surgical targeting and can impact connectomic analyses.
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Affiliation(s)
- Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Angela M Noecker
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Justin K Rajendra
- Scientific and Statistical Computational Core, National Institute of Mental Health, NIH, Bethesda, MD, United States
| | - Robert E Gross
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Cameron C McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States.
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Noecker AM, Choi KS, Riva-Posse P, Gross RE, Mayberg HS, McIntyre CC. StimVision Software: Examples and Applications in Subcallosal Cingulate Deep Brain Stimulation for Depression. Neuromodulation 2017; 21:191-196. [PMID: 28653482 DOI: 10.1111/ner.12625] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 12/07/2016] [Revised: 04/13/2017] [Accepted: 05/04/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Create a software tool to facilitate tractography-based deep brain stimulation (DBS) electrode targeting within the patient-specific stereotactic coordinate system used in the operating room. APPROACH StimVision was developed with Visualization Toolkit libraries and integrates four major components: 1) medical image visualization, 2) tractography visualization, 3) DBS electrode positioning, and 4) DBS activation volume calculation with tractography intersection. RESULTS Initial applications of StimVision are focused on the study of subcallosal cingulate (SCC) DBS for the treatment of depression. Retrospective modeling results on SCC DBS have suggested that direct stimulation of a specific collection of tractographic pathways are necessary for therapeutic benefit; thereby creating a tractography-based DBS surgical targeting hypotheses. StimVision is the tool we created to facilitate prospective clinical evaluation of that hypothesis. SIGNIFICANCE Retrospective tractography-based analyses are common in DBS research; however, intraoperative software tools for interactive selection of a tractography-based DBS target are not readily available. StimVision provides an academic research tool to assist clinical implementation of new DBS targeting strategies and postoperative evaluation of targeting outcome.
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Affiliation(s)
- Angela M Noecker
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Robert E Gross
- Departments of Neurosurgery, Neurology, and Biomedical Engineering, Emory University, Atlanta, GA, USA
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Cameron C McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
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Han YJ, Han DG, Chae JS, Park JH, Park BK, Kim HC, Choi KS. Theileria buffeli infections in grazing cattle in the Republic of Korea. Trop Biomed 2017; 34:263-269. [PMID: 33593006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Theileria infections are encountered worldwide, occasionally resulting in serious economic losses for the livestock industry. This study is an epidemiological survey of Theileria infections in Korean indigenous cattle populations in the Republic of Korea (ROK). Blood samples were collected from 100 cattle in April (n=50) (prior to pastureland grazing), and again four months later, in August (n=50) (half of the cattle put out for grazing and the other half kept in housing). All samples were tested for the presence of Theileria infection based on PCR amplification of the small subunit of ribosomal RNA gene. Twenty-two samples across the whole study were verified as positive for Theileria infection by PCR methods. In August, Theileria infection was markedly increased in grazing cattle (16/25 animals, 64%) compared with indoor cattle (4/25 animals, 16%); affected animals exhibited no clinical signs of infection. The red blood cell, hematocrit, and hemoglobin values were significantly lower in Theileriapositive cattle than in Theileria-negative cattle. Phylogenetic analysis demonstrated that the isolates from this study belonged to the T. buffeli species, and were significantly related to Types A, B, C, and E, and were distinct from T. buffeli Type D, which is known to be more pathogenic. These findings indicate that T. buffeli identified in Korean indigenous cattle have a low-to-mild pathogenicity. These results suggest that the T. buffeli infection is relatively higher in the ROK, and the infection rate may increase following grazing. Taken together, T. buffeli infection may not only be seasonally correlated, but also may be affected by management practices such as pastureland grazing.
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Affiliation(s)
- Y J Han
- College of Ecology and Environmental Science, Kyungpook National University, Sangju 37224, Republic of Korea
| | - D G Han
- College of Ecology and Environmental Science, Kyungpook National University, Sangju 37224, Republic of Korea
| | - J S Chae
- Laboratory of Veterinary Internal Medicine, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - J H Park
- College of Veterinary Medicine, Chonbuk National University, Iksan 54596, Republic of Korea
| | - B K Park
- College of Veterinary Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - H C Kim
- College of Veterinary Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - K S Choi
- College of Ecology and Environmental Science, Kyungpook National University, Sangju 37224, Republic of Korea
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Dunlop BW, Rajendra JK, Craighead WE, Kelley ME, McGrath CL, Choi KS, Kinkead B, Nemeroff CB, Mayberg HS. Functional Connectivity of the Subcallosal Cingulate Cortex And Differential Outcomes to Treatment With Cognitive-Behavioral Therapy or Antidepressant Medication for Major Depressive Disorder. Am J Psychiatry 2017; 174:533-545. [PMID: 28335622 PMCID: PMC5453828 DOI: 10.1176/appi.ajp.2016.16050518] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [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] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this article was to inform the first-line treatment choice between cognitive-behavioral therapy (CBT) or an antidepressant medication for treatment-naive adults with major depressive disorder by defining a neuroimaging biomarker that differentially identifies the outcomes of remission and treatment failure to these interventions. METHOD Functional MRI resting-state functional connectivity analyses using a bilateral subcallosal cingulate cortex (SCC) seed was applied to 122 patients from the Prediction of Remission to Individual and Combined Treatments (PReDICT) study who completed 12 weeks of randomized treatment with CBT or antidepressant medication. Of the 122 participants, 58 achieved remission (Hamilton Depression Rating Scale [HAM-D] score ≤7 at weeks 10 and 12), and 24 had treatment failure (<30% decrease from baseline in HAM-D score). A 2×2 analysis of variance using voxel-wise subsampling permutation tests compared the interaction of treatment and outcome. Receiver operating characteristic curves constructed using brain connectivity measures were used to determine possible classification rates for differential treatment outcomes. RESULTS The resting-state functional connectivity of the following three regions with the SCC was differentially associated with outcomes of remission and treatment failure to CBT and antidepressant medication and survived application of the subsample permutation tests: the left anterior ventrolateral prefrontal cortex/insula, the dorsal midbrain, and the left ventromedial prefrontal cortex. Using the summed SCC functional connectivity scores for these three regions, overall classification rates of 72%-78% for remission and 75%-89% for treatment failure was demonstrated. Positive summed functional connectivity was associated with remission with CBT and treatment failure with medication, whereas negative summed functional connectivity scores were associated with remission to medication and treatment failure with CBT. CONCLUSIONS Imaging-based depression subtypes defined using resting-state functional connectivity differentially identified an individual's probability of remission or treatment failure with first-line treatment options for major depression. This biomarker should be explored in future research through prospective testing and as a component of multivariate treatment prediction models.
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Affiliation(s)
- Boadie W. Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Justin K. Rajendra
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - W. Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Mary E. Kelley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Callie L. McGrath
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Becky Kinkead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Charles B. Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Helen S. Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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Choi KS, Riva-Posse P, Gross RE, Mayberg HS. Mapping the "Depression Switch" During Intraoperative Testing of Subcallosal Cingulate Deep Brain Stimulation. JAMA Neurol 2016; 72:1252-60. [PMID: 26408865 DOI: 10.1001/jamaneurol.2015.2564] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE The clinical utility of monitoring behavioral changes during intraoperative testing of subcallosal cingulate deep brain stimulation is unknown. OBJECTIVE To characterize the structural connectivity correlates of deep brain stimulation-evoked behavioral effects using probabilistic tractography in depression. DESIGN, SETTING, AND PARTICIPANTS Categorization of acute behavioral effects was conducted in 9 adults undergoing deep brain stimulation implantation surgery for chronic treatment-resistant depression in a randomized and blinded testing session at Emory University. Patients were studied from September 1, 2011, through June 30, 2013. Post hoc analyses of the structural tractography patterns mediating distinct categories of evoked behavioral effects were defined, including the best response overall. Data analyses were performed from May 1 through July 1, 2015. MAIN OUTCOMES AND MEASURES Categorization of stimulation-induced transient behavioral effects and delineation of the shared white matter tracts mediating response subtypes. RESULTS Among the 9 patients, 72 active and 36 sham trials were recorded. The following stereotypical behavior patterns were identified: changes in interoceptive (noted changes in body state in 30 of 72 active and 4 of 36 sham trials) and in exteroceptive (shift in attention from patient to others in 9 of 72 active and 0 sham trials) awareness. The best response was a combination of exteroceptive and interoceptive changes at a single left contact for all 9 patients. Structural connectivity showed that the best response contacts had a pattern of connections to the bilateral ventromedial frontal cortex (via forceps minor and left uncinate fasciculus) and to the cingulate cortex (via left cingulum bundle), whereas behaviorally salient but nonbest contacts had only cingulate involvement. The involvement of the 3 white matter bundles during stimulation of the best contacts suggests a mechanism for the observed transient "depression switch." CONCLUSIONS AND RELEVANCE This analysis of transient behavior changes during intraoperative deep brain stimulation of the subcallosal cingulate and the subsequent identification of unique connectivity patterns may provide a biomarker of a rapid-onset depression switch to guide surgical implantation and to refine and optimize algorithms for the selection of contacts in long-term stimulation for treatment-resistant depression.
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Affiliation(s)
- Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Robert E Gross
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia3Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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Kim JY, Kye SJ, Lee HJ, Gaikwad S, Lee HS, Jung SC, Choi KS. Development of a highly immunogenic Newcastle disease virus chicken vaccine strain of duck origin. Poult Sci 2016; 95:790-7. [PMID: 26769266 DOI: 10.3382/ps/pev377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/24/2015] [Accepted: 10/26/2015] [Indexed: 11/20/2022] Open
Abstract
Newcastle disease virus (NDV) strain NDRL0901 was developed as a live vaccine candidate for control of Newcastle disease. NDV isolate KR/duck/13/07 (DK1307) of duck origin was used as the selected vaccine strain. DK1307 was passaged 6 times in chickens. Then a single clone from the chicken-adapted virus (DK1307C) was finally selected, and the vaccine strain was named NDRL0901. DK1307C and the clone NDRL0901 viruses showed enhanced immunogenicity compared to the DK1307 virus. Principal component analysis based on fusion and hemagglutinin-neuraminidase genes revealed the codon usage pattern in the dataset is distinct separating duck viral sequences and avian sequences, and passage of the duck origin virus into the chicken host causes deviation in the codon usage pattern. The NDRL0901 virus was avirulent and did not acquire viral virulence even after 7 back passages in chickens. When day-old chicks were vaccinated with the NDRL0901 virus via spray, eye drops, and drinking water, the vaccinated birds showed no clinical signs and had significant protection efficacy (>80%) against very virulent NDV (Kr005 strain) infection regardless of the administration route employed. The results indicate that the NDRL0901 strain is safe in chickens and can offer protective immunity.
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Affiliation(s)
- J Y Kim
- Avian Disease Division, Animal and Plant Quarantine Agency, Anyang, Republic of Korea
| | - S J Kye
- Foot and Mouth Disease Diagnosis Division, Animal and Plant Quarantine Agency, Anyang, Republic of Korea
| | - H J Lee
- Avian Disease Division, Animal and Plant Quarantine Agency, Anyang, Republic of Korea
| | - S Gaikwad
- Department of Microbiology, College of Veterinary and Animal Sciences, Maharashtra Animal and Fishery Sciences University, Parbhani, 431 402 India
| | - H S Lee
- Bacterial Disease Division, Animal and Plant Quarantine Agency, Anyang, Republic of Korea
| | - S C Jung
- Avian Disease Division, Animal and Plant Quarantine Agency, Anyang, Republic of Korea
| | - K S Choi
- Avian Disease Division, Animal and Plant Quarantine Agency, Anyang, Republic of Korea
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Riva-Posse P, Choi KS, Holtzheimer PE, McIntyre CC, Gross RE, Chaturvedi A, Crowell AL, Garlow SJ, Rajendra JK, Mayberg HS. Defining critical white matter pathways mediating successful subcallosal cingulate deep brain stimulation for treatment-resistant depression. Biol Psychiatry 2014; 76:963-9. [PMID: 24832866 PMCID: PMC4487804 DOI: 10.1016/j.biopsych.2014.03.029] [Citation(s) in RCA: 290] [Impact Index Per Article: 29.0] [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: 10/02/2013] [Revised: 03/18/2014] [Accepted: 03/19/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Subcallosal cingulate white matter (SCC) deep brain stimulation (DBS) is an evolving investigational treatment for depression. Mechanisms of action are hypothesized to involve modulation of activity within a structurally defined network of brain regions involved in mood regulation. Diffusion tensor imaging was used to model white matter connections within this network to identify those critical for successful antidepressant response. METHODS Preoperative high-resolution magnetic resonance imaging data, including diffusion tensor imaging, were acquired in 16 patients with treatment-resistant depression, who then received SCC DBS. Computerized tomography was used postoperatively to locate DBS contacts. The activation volume around the contacts used for chronic stimulation was modeled for each patient retrospectively. Probabilistic tractography was used to delineate the white matter tracts traveling through each activation volume. Patient-specific tract maps were calculated using whole-brain analysis. Clinical evaluations of therapeutic outcome from SCC DBS were defined at 6 months and 2 years. RESULTS Whole-brain activation volume tractography demonstrated that all DBS responders at 6 months (n = 6) and 2 years (n = 12) shared bilateral pathways from their activation volumes to 1) medial frontal cortex via forceps minor and uncinate fasciculus; 2) rostral and dorsal cingulate cortex via the cingulum bundle; and 3) subcortical nuclei. Nonresponders did not consistently show these connections. Specific anatomical coordinates of the active contacts did not discriminate responders from nonresponders. CONCLUSIONS Patient-specific activation volume tractography modeling may identify critical tracts that mediate SCC DBS antidepressant response. This suggests a novel method for patient-specific target and stimulation parameter selection.
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Affiliation(s)
| | - Ki Sueng Choi
- Department of Psychiatry and Behavioral Sciences, Emory University
,The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University
,Biomedical Imaging Technology Center, Georgia Institute of Technology and Emory University
| | - Paul E. Holtzheimer
- Department of Psychiatry and Behavioral Sciences, Emory University
,Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth
| | | | - Robert E. Gross
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University
,Department of Neurology, Emory University
,Department of Neurosurgery, Emory University
| | | | | | - Steven J. Garlow
- Department of Psychiatry and Behavioral Sciences, Emory University
| | | | - Helen S. Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University
,Department of Neurology, Emory University
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Woo SM, Min KJ, Seo BR, Nam JO, Choi KS, Yoo YH, Kwon TK. Cafestol overcomes ABT-737 resistance in Mcl-1-overexpressed renal carcinoma Caki cells through downregulation of Mcl-1 expression and upregulation of Bim expression. Cell Death Dis 2014; 5:e1514. [PMID: 25375379 PMCID: PMC4260730 DOI: 10.1038/cddis.2014.472] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 12/25/2022]
Abstract
Although ABT-737, a small-molecule Bcl-2/Bcl-xL inhibitor, has recently emerged as a novel cancer therapeutic agent, ABT-737-induced apoptosis is often blocked in several types of cancer cells with elevated expression of Mcl-1. Cafestol, one of the major compounds in coffee beans, has been reported to have anti-carcinogenic activity and tumor cell growth-inhibitory activity, and we examined whether cafestol could overcome resistance against ABT-737 in Mcl-1-overexpressed human renal carcinoma Caki cells. ABT-737 alone had no effect on apoptosis, but cafestol markedly enhanced ABT-737-mediated apoptosis in Mcl-1-overexpressed Caki cells, human glioma U251MG cells, and human breast carcinoma MDA-MB231 cells. By contrast, co-treatment with ABT-737 and cafestol did not induce apoptosis in normal human skin fibroblast. Furthermore, combined treatment with cafestol and ABT-737 markedly reduced tumor growth compared with either drug alone in xenograft models. We found that cafestol inhibited Mcl-1 protein expression, which is important for ABT-737 resistance, through promotion of protein degradation. Moreover, cafestol increased Bim expression, and siRNA-mediated suppression of Bim expression reduced the apoptosis induced by cafestol plus ABT-737. Taken together, cafestol may be effectively used to enhance ABT-737 sensitivity in cancer therapy via downregulation of Mcl-1 expression and upregulation of Bim expression.
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Affiliation(s)
- S M Woo
- Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, South Korea
| | - K-J Min
- Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, South Korea
| | - B R Seo
- Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, South Korea
| | - J-O Nam
- Department of Ecological Environment Conservation, Kyungpook National University, Sangju-si, Gyeongsangbuk-do 742-711, South Korea
| | - K S Choi
- Department of Biochemistry, Ajou University School of Medicine, 5 Woncheon-Dong, Paldal-Gu, Suwon 442-749, South Korea
| | - Y H Yoo
- Department of Anatomy and Cell Biology and Mitochondria Hub Regulation Center, Dong-A University College of Medicine, Busan 602-714, South Korea
| | - T K Kwon
- Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, South Korea
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Goban A, Hung CL, Yu SP, Hood JD, Muniz JA, Lee JH, Martin MJ, McClung AC, Choi KS, Chang DE, Painter O, Kimble HJ. Atom-light interactions in photonic crystals. Nat Commun 2014; 5:3808. [PMID: 24806520 DOI: 10.1038/ncomms4808] [Citation(s) in RCA: 319] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 04/02/2014] [Indexed: 11/09/2022] Open
Abstract
The integration of nanophotonics and atomic physics has been a long-sought goal that would open new frontiers for optical physics, including novel quantum transport and many-body phenomena with photon-mediated atomic interactions. Reaching this goal requires surmounting diverse challenges in nanofabrication and atomic manipulation. Here we report the development of a novel integrated optical circuit with a photonic crystal capable of both localizing and interfacing atoms with guided photons. Optical bands of a photonic crystal waveguide are aligned with selected atomic transitions. From reflection spectra measured with average atom number N=1.1+/-0.4, we infer that atoms are localized within the waveguide by optical dipole forces. The fraction of single-atom radiative decay into the waveguide is Γ1D/Γ'≃(0.32±0.08), where Γ1D is the rate of emission into the guided mode and Γ' is the decay rate into all other channels. Γ1D/Γ' is unprecedented in all current atom-photon interfaces.
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Affiliation(s)
- A Goban
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA [3]
| | - C-L Hung
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA [3]
| | - S-P Yu
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA [3]
| | - J D Hood
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA [3]
| | - J A Muniz
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA [3]
| | - J H Lee
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
| | - M J Martin
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
| | - A C McClung
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
| | - K S Choi
- Spin Convergence Research Center 39-1, Korea Institute of Science and Technology, Seoul 136-791, Korea
| | - D E Chang
- ICFO-Institut de Ciencies Fotoniques, Mediterranean Technology Park, 08860 Castelldefels (Barcelona), Spain
| | - O Painter
- 1] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA [2] Thomas J. Watson, Sr., Laboratory of Applied Physics 128-95, California Institute of Technology, Pasadena, California 91125, USA
| | - H J Kimble
- 1] Norman Bridge Laboratory of Physics 12-33, California Institute of Technology, Pasadena, California 91125, USA [2] Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, California 91125, USA
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Choi KS, Holtzheimer PE, Franco AR, Kelley ME, Dunlop BW, Hu XP, Mayberg HS. Reconciling variable findings of white matter integrity in major depressive disorder. Neuropsychopharmacology 2014; 39:1332-9. [PMID: 24352368 PMCID: PMC3988550 DOI: 10.1038/npp.2013.345] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [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: 08/14/2013] [Revised: 11/14/2013] [Accepted: 11/26/2013] [Indexed: 01/19/2023]
Abstract
Diffusion tensor imaging (DTI) has been used to evaluate white matter (WM) integrity in major depressive disorder (MDD), with several studies reporting differences between depressed patients and controls. However, these findings are variable and taken from relatively small studies often using suboptimal analytic approaches. The presented DTI study examined WM integrity in large samples of medication-free MDD patients (n=134) and healthy controls (n=54) using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) approaches, and rigorous statistical thresholds. Compared with health control subjects, MDD patients show no significant differences in fractional anisotropy, radial diffusivity, mean diffusivity, and axonal diffusivity with either the VBM or the TBSS approach. Our findings suggest that disrupted WM integrity does not have a major role in the neurobiology of MDD in this relatively large study using optimal imaging acquisition and analysis; however, this does not eliminate the possibility that certain patient subgroups show WM disruption associated with depression.
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Affiliation(s)
- Ki Sueng Choi
- Department of Psychiatry, Emory University, Atlanta, GA, USA,The Wallace H Coulter, Department of Biomedical Engineering, Biomedical, Imaging Technology Center, Georgia Institute of Technology, Emory University, Atlanta, GA, USA,Department of Psychiatry, Emory University or The Wallace H Coulter, Department of Biomedical Engineering, Biomedical, Imaging Technology Center, Georgia Institute of Technology, Emory University, 101 Woodruff Circle WMB 4306, Atlanta, GA 30345, USA, Tel: +404 727 5528, E-mail:
| | - Paul E Holtzheimer
- Department of Psychiatry, Emory University, Atlanta, GA, USA,Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Alexandre R Franco
- Department of Electrical Engineering, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Mary E Kelley
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Boadie W Dunlop
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Xiaoping P Hu
- The Wallace H Coulter, Department of Biomedical Engineering, Biomedical, Imaging Technology Center, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Helen S Mayberg
- Department of Psychiatry, Emory University, Atlanta, GA, USA,Department of Neurology, Emory University, Atlanta, GA, USA
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Jeong MI, Choi YJ, Joa JH, Choi KS, Chung BN. First Report of Freesia sneak virus in Commercial Freesia hybrida Cultivars in Korea. Plant Dis 2014; 98:162. [PMID: 30708612 DOI: 10.1094/pdis-05-13-0484-pdn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In order to investigate the virus infection rate of commercial freesia cultivars in early February 2013, 19 freesia cultivars showing necrotic purple speckles or streaks on leaves, purple streaks parallel to the midrib, and necrotic speckles on leaves were collected from three different regions (Suwon and Icheon in Gyeonggi Province and Jeonju in North Jeonla Province) and used for virus detection. Nucleic acid extracts were analyzed for detection of major freesia-infecting viruses including Freesia sneak virus (FreSV) by reverse transcription (RT)-PCR with specific primer pairs. The FreSV CP gene was amplified using primer pair FreSV-F (5'-TTAGATAGTGAATCCATAAGCTGC-3') and FreSV-R (5'-ATGTCTGGAAAATACTCCGTCCAA-3'). The approximately 1.3-kb fragment of the FreSV amplified product was cloned and sequenced (GenBank Accession No. KC771891 to 98). The nucleotide sequences of CP gene of FreSV korean isolates showed 99.2 to 99.8% similarity to other FreSV isolates DQ885455, FJ807730, and GU071089, which are registered in GenBank. FreSV was detected from 71.7% of 138 plants tested while the infection rate of Freesia mosaic virus (FreMV) was 34.8%. Neither Bean yellow mosaic virus (BYMV) nor Tobacco rattle virus (TRV) were detected from any plants tested in this study. In certain cultivars, such as 'Bluebau' (II) and 'Pretty women,' most plants planted in the field showed purple streak symptoms on the leaves. In conclusion, FreSV was detected from some symptomatic freesia cultivars showing purple streak or speckles on leaves with or without necrotic spots and necrotic speckles on leaves. FreSV is currently widespread in Korea and some freesia plants were mixed infected with FreMV. FreSV has been occurring in the Netherlands for over 40 years (2). It is a plant virus in the family Ophioviridae and Ophiovirus genus. Once it occurs in freesia plantation fields, eradication is almost impossible because FreSV is transmitted by zoospores of Olpidium brassicae, which is a soilborne root-infecting fungus (3). Resting spores of O. brassicae can remain dormant in the soil and can be infective for 20 years (1). To produce virus-free freesia plants, growers should consider whether or not their fields are contaminated with O. brassicae carrying FreSV. To our knowledge, this is the first report of FreSV in freesia plants in Korea. References: (1) R. N. Campbell. Can. J. Bot. 63:2288, 1985. (2) Y. Koot et al. Tijdschrift over Plantenziekten 60:157, 1954. (3) H. J. M. van Dorst. Neth. J. Plant Pathol. 81:45, 1975.
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Affiliation(s)
- M I Jeong
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-706, Korea
| | - Y J Choi
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-706, Korea
| | - J H Joa
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-706, Korea
| | - K S Choi
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-706, Korea
| | - B N Chung
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-706, Korea
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Lujan JL, Chaturvedi A, Choi KS, Holtzheimer PE, Gross RE, Mayberg HS, McIntyre CC. Tractography-activation models applied to subcallosal cingulate deep brain stimulation. Brain Stimul 2013; 6:737-9. [PMID: 23602025 DOI: 10.1016/j.brs.2013.03.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [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: 11/30/2012] [Revised: 03/18/2013] [Accepted: 03/20/2013] [Indexed: 01/11/2023] Open
Abstract
Deep brain stimulation (DBS) of the subcallosal cingulate white matter (SCCWM) is an experimental therapy for major depressive disorder (MDD). The specific axonal pathways that mediate the anti-depressant effects of DBS remain unknown. Patient-specific tractography-activation models (TAMs) are a new tool to help identify pathways modulated by DBS. TAMs consist of four basic components: 1) anatomical and diffusion-weighted imaging data acquired on the patient; 2) probabilistic tractography from the brain region surrounding the implanted DBS electrode; 3) finite element models of the electric field generated by the patient-specific DBS parameter settings; and 4) application of the DBS electric field to multi-compartment cable models of axons, with trajectories defined by the tractography, to predict action potential generation in specific pathways. This study presents TAM predictions from DBS of the SCCWM in one MDD patient. Our findings suggest that small differences in electrode location can generate substantial differences in the directly activated pathways.
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Affiliation(s)
- J Luis Lujan
- Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, OH, USA
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50
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Ahn JY, Jung HY, Choi JY, Kim MY, Lee JH, Choi KS, Kim DH, Choi KD, Song HJ, Lee GH, Kim JH, Park YS. Natural course of noncurative endoscopic resection of differentiated early gastric cancer. Endoscopy 2012. [PMID: 23188661 DOI: 10.1055/s-0032-1325676] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [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] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND STUDY AIMS Following noncurative endoscopic resection of early gastric cancer (EGC), the patient should be observed when the underlying disease is severe, the patient is elderly, or the patient refuses further treatment. The aim of this study was to analyze the clinical outcomes of patients with differentiated EGC who underwent noncurative endoscopic resection without additional treatment. PATIENTS AND METHODS Included patients underwent noncurative endoscopic resection for differentiated EGC without additional treatment at the Asan Medical Center between July 1994 and January 2009. Clinical and oncological outcomes were analyzed. RESULTS A total of 159 patients were included in the analysis. The median follow-up period was 33 months (interquartile range [IQR] 22 - 52 months). In total, 40 patients died (25.2 %) - 3 due to stomach cancer, 34 due to other causes, and 3 from unknown causes; the median survival time after endoscopic treatment for these patients was 27.5 months (IQR 13.8 - 48.3 months). Multivariate analysis showed that the rates of underlying disease (P < 0.001) and lymphovascular invasion (P = 0.005) were higher among the 40 patients who died than among the 119 survivors. The overall 3- and 5-year survival rates were 82.9 % and 77.1 %, respectively; the rates of the patients with lymphovascular invasion were 61.9 % and 42.4 %, respectively, and the rates of patients without lymphovascular invasion were 86.1 % and 81.8 %, respectively (P < 0.001). CONCLUSIONS Additional treatment provides fewer benefits to patients who do not have long life expectancies. Additional surgery can be considered for patients with lymphovascular invasion because of its high mortality rate; however, the benefits and risks of surgery should be considered carefully.
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Affiliation(s)
- J Y Ahn
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, South Korea
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