Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation

Abstract Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is a promising intervention for treatment-resistant depression (TRD). Despite the failure of a clinical trial, multiple case series have described encouraging results, especially with the introduction of improved surgical proto...

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Autores principales:	Mohammad S. E. Sendi, Allison C. Waters, Vineet Tiruvadi, Patricio Riva-Posse, Andrea Crowell, Faical Isbaine, John T. Gale, Ki Sueng Choi, Robert E. Gross, Helen S. Mayberg, Babak Mahmoudi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Publishing Group 2021
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/37996d8fd2344b0fac327f41704b2596
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spelling	oai:doaj.org-article:37996d8fd2344b0fac327f41704b25962021-11-07T12:17:47ZIntraoperative neural signals predict rapid antidepressant effects of deep brain stimulation10.1038/s41398-021-01669-02158-3188https://doaj.org/article/37996d8fd2344b0fac327f41704b25962021-11-01T00:00:00Zhttps://doi.org/10.1038/s41398-021-01669-0https://doaj.org/toc/2158-3188Abstract Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is a promising intervention for treatment-resistant depression (TRD). Despite the failure of a clinical trial, multiple case series have described encouraging results, especially with the introduction of improved surgical protocols. Recent evidence further suggests that tractography targeting and intraoperative exposure to stimulation enhances early antidepressant effects that further evolve with ongoing chronic DBS. Accelerating treatment gains is critical to the care of this at-risk population, and identification of intraoperative electrophysiological biomarkers of early antidepressant effects will help guide future treatment protocols. Eight patients underwent intraoperative electrophysiological recording when bilateral DBS leads were implanted in the SCC using a connectomic approach at the site previously shown to optimize 6-month treatment outcomes. A machine learning classification method was used to discriminate between intracranial local field potentials (LFPs) recorded at baseline (stimulation-naïve) and after the first exposure to SCC DBS during surgical procedures. Spectral inputs (theta, 4–8 Hz; alpha, 9–12 Hz; beta, 13–30 Hz) to the model were then evaluated for importance to classifier success and tested as predictors of the antidepressant response. A decline in depression scores by 45.6% was observed after 1 week and this early antidepressant response correlated with a decrease in SCC LFP beta power, which most contributed to classifier success. Intraoperative exposure to therapeutic stimulation may result in an acute decrease in symptoms of depression following SCC DBS surgery. The correlation of symptom improvement with an intraoperative reduction in SCC beta power suggests this electrophysiological finding as a biomarker for treatment optimization.Mohammad S. E. SendiAllison C. WatersVineet TiruvadiPatricio Riva-PosseAndrea CrowellFaical IsbaineJohn T. GaleKi Sueng ChoiRobert E. GrossHelen S. MaybergBabak MahmoudiNature Publishing GrouparticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENTranslational Psychiatry, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Mohammad S. E. Sendi Allison C. Waters Vineet Tiruvadi Patricio Riva-Posse Andrea Crowell Faical Isbaine John T. Gale Ki Sueng Choi Robert E. Gross Helen S. Mayberg Babak Mahmoudi Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation
description	Abstract Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is a promising intervention for treatment-resistant depression (TRD). Despite the failure of a clinical trial, multiple case series have described encouraging results, especially with the introduction of improved surgical protocols. Recent evidence further suggests that tractography targeting and intraoperative exposure to stimulation enhances early antidepressant effects that further evolve with ongoing chronic DBS. Accelerating treatment gains is critical to the care of this at-risk population, and identification of intraoperative electrophysiological biomarkers of early antidepressant effects will help guide future treatment protocols. Eight patients underwent intraoperative electrophysiological recording when bilateral DBS leads were implanted in the SCC using a connectomic approach at the site previously shown to optimize 6-month treatment outcomes. A machine learning classification method was used to discriminate between intracranial local field potentials (LFPs) recorded at baseline (stimulation-naïve) and after the first exposure to SCC DBS during surgical procedures. Spectral inputs (theta, 4–8 Hz; alpha, 9–12 Hz; beta, 13–30 Hz) to the model were then evaluated for importance to classifier success and tested as predictors of the antidepressant response. A decline in depression scores by 45.6% was observed after 1 week and this early antidepressant response correlated with a decrease in SCC LFP beta power, which most contributed to classifier success. Intraoperative exposure to therapeutic stimulation may result in an acute decrease in symptoms of depression following SCC DBS surgery. The correlation of symptom improvement with an intraoperative reduction in SCC beta power suggests this electrophysiological finding as a biomarker for treatment optimization.
format	article
author	Mohammad S. E. Sendi Allison C. Waters Vineet Tiruvadi Patricio Riva-Posse Andrea Crowell Faical Isbaine John T. Gale Ki Sueng Choi Robert E. Gross Helen S. Mayberg Babak Mahmoudi
author_facet	Mohammad S. E. Sendi Allison C. Waters Vineet Tiruvadi Patricio Riva-Posse Andrea Crowell Faical Isbaine John T. Gale Ki Sueng Choi Robert E. Gross Helen S. Mayberg Babak Mahmoudi
author_sort	Mohammad S. E. Sendi
title	Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation
title_short	Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation
title_full	Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation
title_fullStr	Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation
title_full_unstemmed	Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation
title_sort	intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation
publisher	Nature Publishing Group
publishDate	2021
url	https://doaj.org/article/37996d8fd2344b0fac327f41704b2596
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Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation

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