Mapping the “Depression Switch” During Intraoperative Testing of Subcallosal Cingulate Deep Brain Stimulation

Choi, Ki Sueng; Riva‐Posse, Patricio; Gross, Robert E.; Mayberg, Helen S.

doi:10.1001/jamaneurol.2015.2564

Cited by 125 publications

(122 citation statements)

References 80 publications

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“…Low dopamine levels [220] in depression impair effortful movements and encoding of prediction errors. In addition, several meta-analyses demonstrate that nodes of the salience network are atrophied in depression [47,48] (as in other illnesses), and the major fibre pathways that link the salience network to other parts of the brain are compromised in depression [221]. Although these findings are broadly consistent with our hypotheses, stronger support still awaits; our hypotheses are, in effect, computational in nature, and so require functional testing on relevant timescales.…”

Section: (C) Inaccurate Precision Signalssupporting

confidence: 82%

An active inference theory of allostasis and interoception in depression

Barrett

Quigley

Hamilton

2016

Phil. Trans. R. Soc. B

435

388

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In this paper, we integrate recent theoretical and empirical developments in predictive coding and active inference accounts of interoception (including the Embodied Predictive Interoception Coding model) with working hypotheses from the theory of constructed emotion to propose a biologically plausible unified theory of the mind that places metabolism and energy regulation (i.e. allostasis), as well as the sensory consequences of that regulation (i.e. interoception), at its core. We then consider the implications of this approach for understanding depression. We speculate that depression is a disorder of allostasis, whose myriad symptoms result from a ‘locked in’ brain that is relatively insensitive to its sensory context. We conclude with a brief discussion of the ways our approach might reveal new insights for the treatment of depression. This article is part of the themed issue ‘Interoception beyond homeostasis: affect, cognition and mental health’.

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Section: (C) Inaccurate Precision Signalssupporting

confidence: 82%

An active inference theory of allostasis and interoception in depression

Barrett

Quigley

Hamilton

2016

Phil. Trans. R. Soc. B

435

388

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“…The minor forceps are described as an important stimulated tract for BA25 DBS as well as in the subcaudate ROI maps of Yang et al [3, 7] and others [6, 11-13]; however, in our study the forceps minor fibres lay consistently outside our ROI, being too rostral, dorsal, and medial to lie within the subcaudate ROI. Given the majority of the fibres of the minor forceps extend across the genu of the corpus callosum before extending rostrally towards the frontal poles, the subcaudate tractotomy lesion is unlikely to affect them unless the lesion extends significantly rostrally and dorsally towards the genu of the corpus callosum.…”

Section: Discussioncontrasting

confidence: 51%

“…Post hoc analysis of likely activated white matter tracts in patients undergoing BA25 DBS who had on-table immediate responses to contact stimulation demonstrated that simultaneous activation of forceps minor, uncinate fasciculus, and the cingulum bundle was most strongly associated with an on-table response (termed by the authors as the depression switch) [13]. …”

Section: Discussionmentioning

confidence: 99%

Subcaudate Tractotomy White Matter Anatomy and Variability: A Diffusion Tensor Imaging Study

Bhatia

Henderson

Hsu

et al. 2018

Stereotact Funct Neurosurg

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Background: Subcaudate tractotomy is a functional ablative procedure performed for treatment-resistant psychiatric disease, targeting the white matter tracts ventral to the head of the caudate nucleus. The white matter anatomy of this region has extensive interindividual variability, and this is thought to impact upon the treatment response to ablative and deep brain stimulation procedures. Objective: We aim to assess in detail the white matter tract anatomy and topographic variability underlying subcaudate tractotomy. Methods: 74 non-depressed adult volunteers underwent MRI including diffusion tensor imaging. Individualized regions of interest were formed in both hemispheres using native non-normalized data to simulate a subcaudate tractotomy. Tractography and analysis were performed and the exact tract locations measured including mean distances and standard deviations to assess variability. Results: The cingulum bundle, uncinate fasciculus, corticostriatal fibres, and corticothalamic fibres were consistently demonstrated. The location of the cingulum bundle was consistent across subjects, but there was extensive interindividual variability in the topographic location of the other tracts. Conclusion: We have demonstrated a detailed analysis of the white matter tracts and their anatomical variability underlying subcaudate tractotomy. This has significant implications for neurosurgical targeting.

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“…Recent studies have further confirmed which of these pathways are necessary for clinically significant effects of DBS. These pathways can now be prospectively characterized in individual patients using DBS parameter models coupled to structural connectivity analyses (Riva-Posse et al, 2014; Choi et al, 2015). …”

Section: Closed-loop Dbsmentioning

confidence: 99%

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Deeb

Giordano

Rossi

et al. 2016

Front. Integr. Neurosci.

Self Cite

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This paper provides an overview of current progress in the technological advances and the use of deep brain stimulation (DBS) to treat neurological and neuropsychiatric disorders, as presented by participants of the Fourth Annual DBS Think Tank, which was convened in March 2016 in conjunction with the Center for Movement Disorders and Neurorestoration at the University of Florida, Gainesveille FL, USA. The Think Tank discussions first focused on policy and advocacy in DBS research and clinical practice, formation of registries, and issues involving the use of DBS in the treatment of Tourette Syndrome. Next, advances in the use of neuroimaging and electrochemical markers to enhance DBS specificity were addressed. Updates on ongoing use and developments of DBS for the treatment of Parkinson's disease, essential tremor, Alzheimer's disease, depression, post-traumatic stress disorder, obesity, addiction were presented, and progress toward innovation(s) in closed-loop applications were discussed. Each section of these proceedings provides updates and highlights of new information as presented at this year's international Think Tank, with a view toward current and near future advancement of the field.

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Mapping the “Depression Switch” During Intraoperative Testing of Subcallosal Cingulate Deep Brain Stimulation

Cited by 125 publications

References 80 publications

An active inference theory of allostasis and interoception in depression

An active inference theory of allostasis and interoception in depression

Subcaudate Tractotomy White Matter Anatomy and Variability: A Diffusion Tensor Imaging Study

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

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