Abstract:
BACKGROUND:Deep brain stimulation (DBS) in the subcallosal cingulate gyrus (SCG) is becoming an effective therapeutic option for treatment resistant depression (TRD). OBJECTIVE/HYPOTHESIS:Identifying the neurophysiological mechanisms altered by DBS may lead to more tailored treatment parameters and enhanced efficacy. METHODS:Twenty TRD patients with implanted DBS in the SCG were recruited. Patients participated in three EEG recording sessions, one with DBS ON, one with DBS randomized to ON or OFF, and one with DBS OFF. During each session, subjects performed N-back working memory tasks, namely the 0-back and 3-back. Fourteen subjects with valid EEG were included in the analysis. Changes in frontal gamma oscillations (30-50 Hz) and coupling between theta (4-7 Hz) and gamma oscillations as a result of DBS stimulation were quantified and correlated with depressive symptoms. RESULTS:DBS stimulation resulted in suppression of frontal oscillations in the ON state relative to the OFF state during the N-back tasks. Greatest suppression was demonstrated in beta and gamma oscillations and most pronounced during the 3-back. Suppression of gamma oscillations in the 3-back correlated with a reduction in depressive symptoms. DBS ON relative to OFF in the 3-back also resulted in an increase in theta-gamma coupling that correlated with a reduction in depressive symptoms. CONCLUSION:Suppression of gamma oscillations and increased theta-gamma coupling through DBS is likely mediated by both SCG activation of inhibitory circuits and an enhancement of plasticity in the frontal cortex. Activation of both pathways may explain the therapeutic properties of DBS in TRD.
journal_name
Brain Stimuljournal_title
Brain stimulationauthors
Sun Y,Giacobbe P,Tang CW,Barr MS,Rajji T,Kennedy SH,Fitzgerald PB,Lozano AM,Wong W,Daskalakis ZJdoi
10.1016/j.brs.2015.06.010subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1033-42issue
6eissn
1935-861Xissn
1876-4754pii
S1935-861X(15)01012-8journal_volume
8pub_type
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