Durable effects of deep brain ultrasonic neuromodulation on major depression: a case report.
Durable effects of deep brain ultrasonic neuromodulation on major depression: a case report.
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脑深部超声神经调节对重性抑郁症的持久影响：病例报告。
DOI：
10.1186/s13256-023-04194-4
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发表时间：
2023-10-28
影响因子：
1
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中科院分区：
文献类型：
--
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严重的抑郁症与胼胝体下扣带皮层的过度活跃有关。以无创方式直接刺激胼胝体下扣带皮层或相关回路的能力将最大限度地增加接受治疗的患者数量。为此，我们开发了一种基于超声波的设备，用于有效无创地调节深部脑回路。在这里，我们描述了该工具在难治性抑郁症患者中的应用。犹他大学机构审查委员会批准了一项临床研究，招募了一名患有严重难治性非精神病性抑郁症的 30 岁白人女性。该患者有电惊厥治疗史，并已完全缓解，但没有持续获益。磁共振成像用于将超声设备与受试者的大脑解剖结构进行配准，并评估神经对刺激的反应。每 4 秒向胼胝体下扣带皮层目标发送一次 30 毫秒的短时低强度超声脉冲，导致目标内功能性磁共振成像血氧水平依赖性活动大幅下降。在重复刺激三个前扣带回目标后，患者的抑郁症状在刺激后 24 小时内消失。此后，患者至少在 44 天内保持缓解状态。这个案例说明了超声神经调节精确参与深层神经回路并触发这些回路的持久治疗重置的潜力。试验注册 ClinicalTrials.gov，NCT05301036。注册日期：2022 年 3 月 29 日，https://clinicaltrials.gov/ct2/show/NCT05301036
Severe forms of depression have been linked to hyperactivity of the subcallosal cingulate cortex. The ability to stimulate the subcallosal cingulate cortex or associated circuits noninvasively and directly would maximize the number of patients who could receive treatment. To this end, we have developed an ultrasound-based device for effective noninvasive modulation of deep brain circuits. Here we describe an application of this tool to an individual with treatment-resistant depression. A 30-year-old Caucasian woman with severe treatment-resistant non-psychotic depression was recruited into a clinical study approved by the Institutional Review Board of the University of Utah. The patient had a history of electroconvulsive therapy with full remission but without sustained benefit. Magnetic resonance imaging was used to coregister the ultrasound device to the subject’s brain anatomy and to evaluate neural responses to stimulation. Brief, 30-millisecond pulses of low-intensity ultrasound delivered into the subcallosal cingulate cortex target every 4 seconds caused a robust decrease in functional magnetic resonance imaging blood-oxygen-level-dependent activity within the target. Following repeated stimulation of three anterior cingulate targets, the patient’s depressive symptoms resolved within 24 hours of the stimulation. The patient remained in remission for at least 44 days afterwards. This case illustrates the potential for ultrasonic neuromodulation to precisely engage deep neural circuits and to trigger a durable therapeutic reset of those circuits. Trial registration ClinicalTrials.gov, NCT05301036. Registered 29 March 2022, https://clinicaltrials.gov/ct2/show/NCT05301036
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影响因子：
7.7
作者：
Munoz, F.;Meaney, A.;Gross, A.;Liu, K.;Pouliopoulos, A. N.;Liu, D.;Konofagou, E. E.;Ferrera, V. P.
通讯作者：
Ferrera, V. P.
影响因子：
10.6
作者：
Riva-Posse P;Choi KS;Holtzheimer PE;McIntyre CC;Gross RE;Chaturvedi A;Crowell AL;Garlow SJ;Rajendra JK;Mayberg HS
通讯作者：
Mayberg HS
影响因子：
3.3
作者：
Drevets, Wayne C.;Savitz, Jonathan
通讯作者：
Savitz, Jonathan
影响因子：
16.2
作者：
Folloni, Davide;Verhagen, Lennart;Sallet, Jerome
通讯作者：
Sallet, Jerome
影响因子：
4.1
作者：
Kubanek J
通讯作者：
Kubanek J