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Related Concept Videos

Brain Imaging01:14

Brain Imaging

380
Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans),  magnetic resonance imaging (MRI),  functional magnetic resonance imaging (fMRI), and Transcranial Magnetic...
380

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3T MRI of rapid brain activity changes driven by subcallosal cingulate deep brain stimulation.

Gavin J B Elias1,2, Jürgen Germann1,2, Alexandre Boutet1,2,3

  • 1Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada.

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Summary

Deep brain stimulation for mood disorders modulates brain activity in key areas like the dorsal anterior cingulate cortex. These acute changes predict long-term antidepressant improvement, aiding personalized treatment.

Keywords:
anterior cingulate cortexdeep brain stimulationdepressionfunctional magnetic resonance imagingsubcallosal cingulate

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Imaging

Background:

  • Deep brain stimulation (DBS) of the subcallosal cingulate area shows promise for treatment-resistant mood disorders.
  • The precise brain regions directly affected by subcallosal cingulate DBS are not fully understood.
  • Understanding these network-level effects is crucial for optimizing DBS therapy.

Purpose of the Study:

  • To map the acute brain changes induced by subcallosal cingulate deep brain stimulation (scC-DBS) using functional MRI.
  • To identify brain areas modulated by scC-DBS and explore their relationship with mood fluctuations and clinical outcomes.
  • To investigate potential acute biomarkers for predicting long-term antidepressant response to scC-DBS.

Main Methods:

  • Functional MRI (fMRI) was used to assess brain activity in 12 patients with scC-DBS devices during inactive, optimal, and suboptimal stimulation.
  • Analysis focused on the amplitude of low-frequency fluctuations (ALFF) during resting-state scans.
  • A validation cohort of 4 additional patients was included to confirm findings.

Main Results:

  • Clinically optimal scC-DBS reduced spontaneous brain activity in the dorsal anterior cingulate cortex, posterior cingulate cortex, precuneus, and inferior parietal lobule.
  • Reduced activity in the dorsal anterior cingulate cortex correlated with mood changes and was linked to cingulum bundle engagement.
  • Changes in the dorsal anterior cingulate cortex, posterior cingulate cortex, and precuneus predicted long-term antidepressant improvement, with a predictive model explaining 55% of variance in the primary cohort and 93% in the validation cohort.
  • Significant functional connectivity changes were observed in these areas between active and inactive DBS states.

Conclusions:

  • Subcallosal cingulate deep brain stimulation acutely modulates activity in specific corticolimbic and parietal regions.
  • Immediate changes in dorsal anterior cingulate cortex, posterior cingulate cortex, and precuneus activity serve as reliable predictors of long-term antidepressant response.
  • These findings offer insights into scC-DBS mechanisms and highlight potential biomarkers for personalized treatment optimization.