Axonal pathways linked to therapeutic and nontherapeutic outcomes during psychiatric deep brain stimulation.
Axonal pathways linked to therapeutic and nontherapeutic outcomes during psychiatric deep brain stimulation.
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DOI：
10.1002/hbm.21262
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发表时间：
2012-04
影响因子：
4.8
通讯作者：
McIntyre, Cameron C.
中科院分区：
文献类型：
--
作者：
Lujan, J. Luis;Chaturvedi, Ashutosh;Malone, Donald A.;Rezai, Ali R.;Machado, Andre G.;McIntyre, Cameron C.
关键词：
我们工作的基本假设是，在脑深部电刺激（DBS）过程中，通过选择性激活特定的轴突通路，可以实现特定的临床神经精神益处。因此，本研究的目标是开发一种方法，用于识别轴突通路，其激活对于DBS期间实现治疗益处最有可能是必要的。我们的方法结合了临床数据、弥散张量纤维束成像和患者特异性神经刺激的计算机模型，以识别DBS激活的特定轴突通路，并确定其与个体临床结局指标的相关性。我们使用这种方法来评估一个队列的7名难治性抑郁症患者接受DBS的腹侧前内囊和腹侧纹状体（VC/VS）。临床反应者表现出五个轴突通路，持续激活DBS。所有五个途径当然外侧和内侧的VS或背侧和外侧的延髓核，然而，他们的具体轨迹的细节不同。同样，在无应答者中确定了一个共同途径。我们的方法和初步结果提供了重要的背景研究，旨在扩大科学表征的神经回路与特定的精神疾病的结果从DBS。此外，识别与治疗受益相关的通路为改善DBS器械的手术靶点和刺激设置的临床选择提供了机会。
The underlying hypothesis of our work is that specific clinical neuropsychiatric benefits can be achieved by selective activation of specific axonal pathways during deep brain stimulation (DBS). As such, the goal of this study was to develop a method for identifying axonal pathways whose activation is most likely necessary for achieving therapeutic benefits during DBS. Our approach combined clinical data, diffusion tensor tractography, and computer models of patient-specific neurostimulation to identify particular axonal pathways activated by DBS and determine their correlations with individual clinical outcome measures. We used this method to evaluate a cohort of seven treatment-resistant depression patients treated with DBS of the ventral anterior internal capsule and ventral striatum (VC/VS). Clinical responders exhibited five axonal pathways that were consistently activated by DBS. All five pathways coursed lateral and medial to the VS or dorsal and lateral to the nucleus accumbens; however, details of their specific trajectories differed. Similarly, one common pathway was identified across nonresponders. Our method and preliminary results provide important background for studies aiming to expand scientific characterization of neural circuitry associated with specific psychiatric outcomes from DBS. Furthermore, identification of pathways linked to therapeutic benefit provides opportunities to improve clinical selection of surgical targets and stimulation settings for DBS devices.
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影响因子：
10.6
作者：
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