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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
Published on: January 7, 2019
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Initial Unilateral Exposure to Deep Brain Stimulation in Treatment-Resistant Depression Patients Alters Spectral
Otis Smart1, Ki S Choi2, Patricio Riva-Posse2
1Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States.
Frontiers in Computational Neuroscience
|June 29, 2018
Summary
Deep Brain Stimulation (DBS) for treatment-resistant depression shows hemisphere-specific brainwave changes. Left-sided stimulation of the subcallosal cingulate region revealed distinct theta band decreases, suggesting a potential biomarker for optimal contact targeting.
Area of Science:
- Neuroscience
- Neurosurgery
- Psychiatry
Background:
- High-frequency Deep Brain Stimulation (DBS) of the subcallosal cingulate (SCC) is a novel strategy for treatment-resistant depression (TRD).
- Understanding target engagement during DBS implantation is crucial for optimizing treatment outcomes.
- Local field potentials (LFPs) offer a potential electrophysiological marker for assessing target engagement.
Purpose of the Study:
- To identify a putative electrophysiological measure of target engagement during SCC DBS lead implantation.
- To examine changes in SCC LFPs following transient, unilateral stimulation at the optimal electrode contact.
- To investigate hemisphere-specific oscillatory changes as potential biomarkers for optimal contact selection.
Main Methods:
- Bilateral SCC DBS lead implantation in 14 TRD patients.
- LFP recordings from all electrodes during randomized stimulation testing.
- Analysis of spectral power changes before and after unilateral stimulation at optimal contacts.
Main Results:
- Lateralized and asymmetric power spectral density changes observed in the SCC with acute unilateral stimulation.
- Left stimulation decreased ipsilateral theta, alpha, beta, and gamma bands; right stimulation decreased only beta and gamma bands.
- Left-sided optimal stimulation showed robust and specific decreases in theta power, suggesting a potential functional biomarker.
Conclusions:
- Hemisphere-specific oscillatory changes detected intraoperatively can indicate contacts that yield antidepressant effects.
- Left-sided theta decreases represent a potential target engagement signal for optimizing SCC DBS.
- Further research combining neuroimaging and electrophysiological data may refine biomarkers and improve DBS procedures for TRD.
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