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Neuroanatomical predictors of response to subcallosal cingulate deep brain stimulation for treatment-resistant depression
Sankar, Tejas; Chakravarty, M. Mallar; Jawa, Natasha; Li, Stanley X.; Giacobbe, Peter; Kennedy, Sidney H.; Rizvi, Sakina J.; Mayberg, Helen S.; Hamani, Clement; Lozano, Andres M..
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  • Sankar T; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Chakravarty MM; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Jawa N; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Li SX; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Giacobbe P; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Kennedy SH; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Rizvi SJ; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Mayberg HS; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Hamani C; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
  • Lozano AM; From the Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada (Sankar); the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (Chakravarty); the Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada (Chakravarty); t
J Psychiatry Neurosci ; 45(1): 45-54, 2020 01 01.
Article en En | MEDLINE | ID: mdl-31525860
Background: Deep brain stimulation targeting the subcallosal cingulate gyrus (SCG DBS) improves the symptoms of treatment-resistant depression in some patients, but not in others. We hypothesized that there are pre-existing structural brain differences between responders and nonresponders to SCG DBS, detectable using structural MRI. Methods: We studied preoperative, T1-weighted MRI scans of 27 patients treated with SCG DBS from 2003 to 2011. Responders (n = 15) were patients with a >50% improvement in Hamilton Rating Scale for Depression score following 12 months of SCG DBS. Preoperative subcallosal cingulate gyrus grey matter volume was obtained using manual segmentation by a trained observer blinded to patient identity. Volumes of hippocampus, thalamus, amygdala, whole-brain cortical grey matter and white matter volume were obtained using automated techniques. Results: Preoperative subcallosal cingulate gyrus, thalamic and amygdalar volumes were significantly larger in patients who went on to respond to SCG-DBS. Hippocampal volume did not differ between groups. Cortical grey matter volume was significantly smaller in responders, and cortical grey matter:white matter ratio distinguished between responders and nonresponders with high sensitivity and specificity. Limitations: Normalization by intracranial volume nullified some between-group differences in volumetric measures. Conclusion: There are structural brain differences between patients with treatment-resistant depression who respond to SCG DBS and those who do not. Specifically, the structural integrity of the subcallosal cingulate gyrus target region and its connected subcortical areas, and variations in cortical volume across the entire brain, appear to be important determinants of response. Structural MRI shows promise as a biomarker in deep brain stimulation for depression, and may play a role in refining patient selection for future trials.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Evaluación de Resultado en la Atención de Salud / Estimulación Encefálica Profunda / Trastorno Depresivo Resistente al Tratamiento / Sustancia Gris / Sustancia Blanca / Giro del Cíngulo Tipo de estudio: Guideline / Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Psychiatry Neurosci Asunto de la revista: NEUROLOGIA / PSIQUIATRIA Año: 2020 Tipo del documento: Article
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Evaluación de Resultado en la Atención de Salud / Estimulación Encefálica Profunda / Trastorno Depresivo Resistente al Tratamiento / Sustancia Gris / Sustancia Blanca / Giro del Cíngulo Tipo de estudio: Guideline / Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Psychiatry Neurosci Asunto de la revista: NEUROLOGIA / PSIQUIATRIA Año: 2020 Tipo del documento: Article