최기성 (Icahn School of Medicine at Mount Sinai) | 한빛사논문 > 한빛사

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조회330

최기성Ki Sueng Choi

Icahn School of Medicine at Mount Sinai

Mol. Psychiatr., Nov 02 2023, | https://doi.org/10.1038/s41380-023-02306-6 Whole brain network effects of subcallosal cingulate deep brain stimulation for treatment-resistant depression

Jungho Cha¹, Ki Sueng Choi¹, Justin K. Rajendra², Callie L. McGrath³, Patricio Riva-Posse⁴, Paul E. Holtzheimer⁵, Martijn Figee¹, Brian H. Kopell¹and Helen S. Mayberg¹

¹Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

²Scientific and Statistical Computational Core, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.

³EQRx, Cambridge, MA, USA.

⁴Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.

⁵Department of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.

Corresponding author : Correspondence to Ki Sueng Choi.

Abstract

Ongoing experimental studies of subcallosal cingulate deep brain stimulation (SCC DBS) for treatment-resistant depression (TRD) show a differential timeline of behavioral effects with rapid changes after initial stimulation, and both early and delayed changes over the course of ongoing chronic stimulation. This study examined the longitudinal resting-state regional cerebral blood flow (rCBF) changes in intrinsic connectivity networks (ICNs) with SCC DBS for TRD over 6 months and repeated the same analysis by glucose metabolite changes in a new cohort. A total of twenty-two patients with TRD, 17 [15 O]-water and 5 [18 F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) patients, received SCC DBS and were followed weekly for 7 months. PET scans were collected at 4-time points: baseline, 1-month after surgery, and 1 and 6 months of chronic stimulation. A linear mixed model was conducted to examine the differential trajectory of rCBF changes over time. Post-hoc tests were also examined to assess postoperative, early, and late ICN changes and response-specific effects. SCC DBS had significant time-specific effects in the salience network (SN) and the default mode network (DMN). The rCBF in SN and DMN was decreased after surgery, but responder and non-responders diverged thereafter, with a net increase in DMN activity in responders with chronic stimulation. Additionally, the rCBF in the DMN uniquely correlated with depression severity. The glucose metabolic changes in a second cohort show the same DMN changes. The trajectory of PET changes with SCC DBS is not linear, consistent with the chronology of therapeutic effects. These data provide novel evidence of both an acute reset and ongoing plastic effects in the DMN that may provide future biomarkers to track clinical improvement with ongoing treatment.

논문정보

형식Research article
게재일2023년 11월 (BRIC 등록일 2023-11-17)
연구진국외 연구진
분야 바이오·의료융합 > 뇌인지과학

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