Related Experiment Video
Updated: Jan 6, 2026
05:19
Author Spotlight: Therapeutic Benefit of Closed-Loop Deep Brain Stimulation in Depression Treatment
Published on: July 7, 2023
3.2K
Mapping the "Depression Switch" During Intraoperative Testing of Subcallosal Cingulate Deep Brain Stimulation
Ki Sueng Choi1, Patricio Riva-Posse1, Robert E Gross2
1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
JAMA Neurology
|September 27, 2015
Summary
Monitoring behavioral changes during deep brain stimulation (DBS) for depression revealed specific connectivity patterns. These findings may help optimize DBS targeting for treatment-resistant depression.
Area of Science:
- Neuroscience
- Neurosurgery
- Psychiatry
Background:
- The clinical utility of monitoring behavioral changes during intraoperative deep brain stimulation (DBS) for subcallosal cingulate in depression is not well understood.
- Understanding the neural correlates of acute behavioral effects during DBS surgery is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To characterize the structural connectivity patterns associated with DBS-evoked behavioral effects in patients with depression.
- To identify potential biomarkers for guiding surgical implantation and refining stimulation parameters.
Main Methods:
- Nine adults with treatment-resistant depression underwent intraoperative DBS testing with randomized, blinded trials.
- Behavioral effects were categorized, and post hoc probabilistic tractography was used to analyze white matter connections of effective stimulation contacts.
- Analysis focused on identifying structural connectivity correlates of distinct behavioral response subtypes.
Main Results:
- Stereotypical behavioral patterns, including changes in interoceptive and exteroceptive awareness, were observed during active stimulation.
- The optimal response involved a combination of exteroceptive and interoceptive changes, consistently linked to stimulation of a specific left contact.
- Structural connectivity analysis revealed that optimal stimulation contacts connected to the ventromedial frontal cortex and cingulate cortex via specific white matter tracts (e.g., forceps minor, uncinate fasciculus, cingulum bundle).
Conclusions:
- Transient behavioral changes during intraoperative DBS of the subcallosal cingulate are associated with distinct structural connectivity patterns.
- These connectivity patterns may serve as biomarkers for a rapid-onset depression switch, aiding in surgical targeting and contact selection for long-term DBS.
- This approach could refine algorithms for optimizing deep brain stimulation in treatment-resistant depression.
