Using probabilistic tractography to target the subcallosal cingulate cortex in patients with treatment resistant depression

Evangelia Tsolaki; Randall Espinoza; Nader Pouratian

doi:10.1016/j.pscychresns.2017.01.006

Using probabilistic tractography to target the subcallosal cingulate cortex in patients with treatment resistant depression

Psychiatry Res Neuroimaging. 2017 Mar 30:261:72-74. doi: 10.1016/j.pscychresns.2017.01.006. Epub 2017 Jan 20.

Authors

Evangelia Tsolaki¹, Randall Espinoza², Nader Pouratian³

Affiliations

¹ Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: [email protected].
² Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: [email protected].
³ Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: [email protected].

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.

Keywords: Deep brain stimulation; Depression; Probabilistic tractography.

MeSH terms

Adult
Deep Brain Stimulation / methods*
Depressive Disorder, Treatment-Resistant / diagnostic imaging*
Depressive Disorder, Treatment-Resistant / therapy*
Female
Gyrus Cinguli / diagnostic imaging*
Humans
Magnetic Resonance Imaging / methods*
Male

Grants and funding

K23 EB014326/EB/NIBIB NIH HHS/United States