summary: Deep brain stimulation applied to a small brain region associated with reward and motivation resulted in metabolic changes at 12 months post-transplantation and reduced some symptoms of depression for people with treatment-resistant depression.
Source: UT Houston
Deep brain stimulation (DBS) in the supralateral branch of the medial forebrain bundle (MFB), which is associated with reward and motivation, revealed metabolic brain changes at 12 months after DBS implantation, making it the most vulnerable to treatment-resistant depression. became a strong potential therapy for According to researchers at UHealth Houston.
The results of the study, which involved 10 patients, were published today. molecular psychiatry,
“It’s something that people have been trying to do for a long time, but we haven’t always been successful in using DBS for psychiatric illnesses,” said first author Christopher Conner, MD, PhD, a former neurosurgery resident. . of neurosurgery at McGovern Medical School at UTHealth Houston. Smith Department.
“But what this PET study shows is that we are changing how the brain is working over the long term and we are starting to change the way the brain starts to organize and process information and data.” are doing.” Connor is currently a fellow with the University of Toronto.
For years, DBS has been used to treat patients suffering from movement disorders such as Parkinson’s disease, tremors, and dystonia, and has been studied as a potential treatment for patients with treatment-resistant depression. In DBS, electrodes are implanted in certain areas of the brain, where they generate electrical impulses to influence brain activity.
However, figuring out which part of the brain needs to be targeted for long-term depression treatment has been challenging.
“We targeted a bundle of fibers that leaves this small area of the brain to travel to other areas throughout the brain,” Conner said.
“The PET scan indicated that the downstream effect is very diffuse in this small target region. It is not a stand-alone effect because not a single area of the brain is associated with depression. The whole brain needs to be changed and this one small This is what we were able to do through Target.
Researchers performed an initial PET scan prior to the DBS procedure on 10 patients in the study to image a baseline. They underwent additional PET scans at six and 12 months to assess changes after treatment. Scans from 8 out of 10 patients showed a response.
“Response to treatment means that your depression is potentially reduced by at least 50%; you’re feeling a lot better,” said co-author Joo de Quevedo, MD, PhD, of Louis A. Felles, MD, of the Department of Psychiatry and Behavioral Sciences at McGovern Medical School.
“So, for patients with severe chronic treatment-resistant depression, reducing our symptoms by half is a lot. That’s the difference between being disabled and being able to do something. Correlating with changes in the PET image, our patients showed.” Told that his depression subsided after treatment. De Quevedo also serves as director of the Translational Psychiatry Program and the Treatment-Resistant Depression Program, part of the Center of Excellence on Mood Disorders.
About this depression and DBS research news
Author: Press Office
Source: UT Houston
contact: Press Office – UT Houston
image: Image is in public domain
Basic Research: closed access.
Christopher R. “Brain Metabolic Changes and Clinical Response to Supralateral Medial Forebrain Bundle Deep Brain Stimulation for Treatment-Resistant Depression” by Conner et al. molecular psychiatry
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essence
Changes in brain metabolism and clinical response to supralateral medial forebrain bundle deep brain stimulation for treatment-resistant depression
Deep brain stimulation (DBS) to the supralateral branch of the medial forebrain bundle is an effective treatment for treatment-resistant depression, providing rapid antidepressant effects. In this study, we use 18F-fluorodeoxyglucose-positron emission tomography (PET) comparison to baseline to identify brain metabolic changes at 12 months after DBS implantation in ten of our patients.
The primary outcome measure was a 50% reduction in the Montgomery–Asberg Depression Rating Scale (MADRS) score, which was interpreted as response. Deterministic fiber tracking was used to map the fixed area individually; Probabilistic tractography was used to identify modified fiber tracts modeled using cathodal contacts.
Of the ten patients included in this study, eight were responders. PET imaging revealed significant reductions in bilateral caudate, mediodorsal thalamus, and dorsal anterior cingulate cortex metabolism that was evident at 6 months and persisted for 12 months after surgery.
At 12 months after surgery, significant left ventral prefrontal cortical metabolic reduction was also observed. The mean reduction in right caudal metabolism over 12 months was correlated with a decrease in MADRS. Probabilistic tractography modeling revealed that such metabolic alterations are associated with cortico-limbic nodes structurally linked to the DBS target site.
Such observed metabolic changes following DBS correlated with clinical response provide insight into how future studies may expand such data to generate biomarkers to predict response, the development of which This would require multimodal imaging analysis.
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