Using probabilistic tractography to target the subcallosal cingulate cortex in patients with treatment resistant depression. (30th March 2017)

• Record Type: Journal Article
• Authors: Tsolaki, Evangelia; Espinoza, Randall; Pouratian, Nader
• Is Part Of: Psychiatry research. Volume 261(2017)
• Page Start: 72
• Page End: 74
• Publication Date: 2017-03-30
• Subjects: Depression -- Deep brain stimulation -- Probabilistic tractography; Psychiatry -- Periodicals; Brain -- Imaging -- Periodicals; Psychiatry -- Periodicals; Diagnostic Imaging -- Periodicals; Psychiatrie -- Périodiques; Cerveau -- Imagerie pour le diagnostic -- Périodiques; 616.890754
• DOI: 10.1016/j.pscychresns.2017.01.006
• Languages: English
• ISSNs: 0925-4927

Abstract

Abstract: The lack of efficacy of deep brain stimulation (DBS) of subcallosal cingulate (SCC) in treatment resistant depression (TRD) may be due in part to suboptimal targeting. In two patients treated with SCC DBS for TRD we assessed the voxel-wise probabilistic connectivity of SCC with four tractography-defined target areas implicated in depression, thereby identifying the tractography-optimized target (TOT). Compared to the non-responder, the responder's DBS leads were implanted and stimulation was delivered closer to the TOT. This automated patient-specific data-driven approach provides tomographic maps that could guide DBS targeting and programming with possible implications for improving response to DBS. Highlights: A novel method for localizing the subcallosal cingulate target for DBS is proposed. Connectivity-defined targets and probabilistic tractography are employed. A resulting tomographic map can be used for both DBS targeting and programing. Proximity of stimulation to the tractography-optimized target may alter DBS response. Preliminary findings reported require prospective evaluation in larger cohort.