Cingulate dynamics track depression recovery with deep brain stimulation
推荐理由
发现并证明了一种客观生物标志物在个性化SCC DBS管理中的效用，并为TRD病理的多方面(功能，解剖和行为)特征之间的关系提供了新的见解
| 文章简介 | |
|---|---|
| 期刊 | NATURE |
| 发表年份 | 2023 |
| DOI | https://doi.org/10.1038/s41586-023-06541-3 |
| 类型 | 研究性工作 |
| 领域 | DBS治疗抑郁症 |
| 引用量 | 13 |
| 推荐信息 | |
|---|---|
| 推荐人 | 温小妍 |
| 审核 | 胡春华 |
| 推荐小组 | 抑郁小组 |
摘要
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.
细分领域
< | SCC DBS