Closed-loop neuromodulation in an individual with treatment-resistant depression

Scangos, Katherine W.; Khambhati, Ankit N.; Daly, Patrick M.; Makhoul, Ghassan S.; Sugrue, Leo P.; Zamanian, Hashem; Liu, Tony X; Rao, Vikram R.; Sellers, Kristin K.; Dawes, Heather E.; Starr, Philip A.; Krystal, Andrew D.; Chang, Edward F.

doi:10.1038/s41591-021-01480-w

Cited by 315 publications

(214 citation statements)

References 35 publications

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“…Interestingly, fast spiking interneurons, the more strongly affected neuronal population in our 5-HT PS experiments are key players in the generation and maintenance of cortical gamma oscillations ( Cardin et al, 2009 ). As limbic gamma oscillations are important in the maintenance of a healthy mood and are affected in major depression ( Scangos et al, 2021 ) the effects of 5-HT described here could be also relevant for the (patho)physiology of higher brain functions.…”

Section: Discussionmentioning

confidence: 98%

Differential Serotonergic Modulation of Principal Neurons and Interneurons in the Anterior Piriform Cortex

Piszár

Lőrincz

2022

Front. Neuroanat.

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Originating from the brainstem raphe nuclei, serotonin is an important neuromodulator involved in a variety of physiological and pathological functions. Specific optogenetic stimulation of serotonergic neurons results in the divisive suppression of spontaneous, but not sensory evoked activity in the majority of neurons in the primary olfactory cortex and an increase in firing in a minority of neurons. To reveal the mechanisms involved in this dual serotonergic control of cortical activity we used a combination of in vitro electrophysiological recordings from identified neurons in the primary olfactory cortex, optogenetics and pharmacology and found that serotonin suppressed the activity of principal neurons, but excited local interneurons. The results have important implications in sensory information processing and other functions of the olfactory cortex and related brain areas.

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Section: Discussionmentioning

confidence: 98%

Differential Serotonergic Modulation of Principal Neurons and Interneurons in the Anterior Piriform Cortex

Piszár

Lőrincz

2022

Front. Neuroanat.

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“…Open-loop NBM-DBS may, thus, fail to interact purposefully with networks underlying memory and cognition. Novel approaches employing closed-loop neuromodulation for treatment-resistant depression [34] and enhancement of cognitive control [35] are slowly emerging and may offer valuable insights for individualizing NBM-DBS. A pressing challenge that may aid problems is identifying a biomarker for cognitive functioning, which could allow refining stimulus delivery.…”

Section: Discussionmentioning

confidence: 99%

Serendipitous Stimulation of Nucleus Basalis of Meynert—The Effect of Unintentional, Long-Term High-Frequency Stimulation on Cognition in Parkinson’s Disease

Bogdan

Oterdoom

Laar

et al. 2022

JCM

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There is a growing interest in deep brain stimulation (DBS) of the nucleus basalis of Meynert (NBM) as a potential therapeutic modality for Parkinson’s disease dementia (PDD). Low-frequency stimulation has yielded encouraging results in individual patients; however, these are not yet sustained in larger studies. With the aim to expand the understanding of NBM-DBS, we share our experience with serendipitous NBM-DBS in patients treated with DBS of the internal Globus pallidus (GPi) for Parkinson’s disease. Since NBM is anatomically located ventral to GPi, several GPi-treated patients appeared to have the distal contact of DBS-electrode(s) positioned in the NBM. We hypothesized that unintentional high-frequency NBM-DBS over a period of one year would result in the opposite effect of low-frequency NBM-stimulation and cause cognitive decline. We studied a cohort of 33 patients with bilateral high-frequency DBS in the GPi for Parkinson’s disease, of which twelve were unintentionally co-stimulated in NBM. The subgroups of unintentional unilateral (N = 7) and bilateral NBM-DBS (N = 5) were compared to the control group of bilateral GPi-DBS (N = 11). Here, we show that unintentional high-frequency NBM-DBS did not cause a significantly faster decline in cognitive function. Further research is warranted for characterizing the therapeutic role of NBM-DBS.

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“…Recently, multi-day intracranial electrophysiology was used to identify a biomarker for depressive symptoms in an individual and identify a brain region to target in surgery. Subsequently, a chronic deep brain sensing and stimulation device was implanted to resolve depressive symptoms [25]. However, this innovative approach needs further validation.…”

Section: Evidence In Humansmentioning

confidence: 99%

Methodological Considerations for Setting Up Deep Brain Stimulation Studies for New Indications

Devos

Temel

Ackermans

et al. 2022

JCM

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Deep brain stimulation (DBS) is a neurosurgical treatment with a growing range of indications. The number of clinical studies is expanding because of DBS for new indications and efforts to improve DBS for existing indications. To date, various methods have been used to perform DBS studies. Designing a clinical intervention study with active implantable medical devices has specific challenges while expanding patient treatment. This paper provides an overview of the key aspects that are essential for setting up a DBS study.

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Closed-loop neuromodulation in an individual with treatment-resistant depression

Cited by 315 publications

References 35 publications

Differential Serotonergic Modulation of Principal Neurons and Interneurons in the Anterior Piriform Cortex

Differential Serotonergic Modulation of Principal Neurons and Interneurons in the Anterior Piriform Cortex

Serendipitous Stimulation of Nucleus Basalis of Meynert—The Effect of Unintentional, Long-Term High-Frequency Stimulation on Cognition in Parkinson’s Disease

Methodological Considerations for Setting Up Deep Brain Stimulation Studies for New Indications

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