Toward Connectomic Deep Brain Stimulation in Obsessive Compulsive Disorder

强迫症中的连接组深部脑刺激

• 批准号: 10671011
• 负责人: Andreas Horn
• 金额: $ 79.25万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671011
• 关键词: Address; Anxiety; Atlases; Brain; Brain region; Classification; Clinical; Clinical Trials; Data; Data Analyses; Data Set; Databases; Deep Brain Stimulation; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Disease remission; Functional Magnetic Resonance Imaging; Future; Goals; Human; Individual; Individual Differences; Lead; Link; Location; Maps; Measures; Mediating; Mental Depression; Mental disorders; Methods; Modality; Modeling; Nature; Obsession; Obsessive compulsive behavior; Obsessive-Compulsive Disorder; Operative Surgical Procedures; Outcome; Patients; Performance; Procedures; Publishing; Refractory; Research; Rest; Sampling; Scanning; Site; Symptoms; Techniques; Testing; Training; Translating; Validation; burden of illness; clinical practice; clinical predictors; cohort; common symptom; comorbidity; compulsion; connectome; connectome data; conventional therapy; design; design verification; disability; improved; individual patient; interest; neuroregulation; novel; predictive modeling; prospective; response; secondary analysis; symptomatic improvement; treatment optimization

PROJECT SUMMARY: Toward Connectomic Deep Brain Stimulation in Obsessive Compulsive Disorder Obsessive-Compulsive-Disorder is a leading cause of disability worldwide with about 10% of patients that are refractory to conventional treatment while suffering from substantial burden of disease. Deep Brain Stimulation (DBS) is a treatment option for these patients, but while some respond excellently to this invasive procedure, not all patients do. One reason could be that we conceptualize DBS to modulate a brain region, rather than a brain network. The goal of this project is to causally link symptom specific improvements in OCD to the stimulation of specific brain networks. By doing so, we will be able to derive symptom-specific network targets for treatment in DBS. In our preliminary research, we identified a specific network target that was associated with optimal response following DBS to four different surgical targets applied world-wide. Our findings were based on the largest multi-center OCD cohort with DBS studied to date (N = 50) and have been confirmed by four additional centers since they were published. While results are promising, three gaps remain before moving toward prospective clinical trials. The aim of this R01 will be to close these gaps. First, we have defined optimal networks by means of structural and functional connectivity but, so far, it remains unclear which of these two modalities (or a combination of both) is best suited to guide DBS. Second, while modulating the network leads to optimal response on a group level, OCD is a heterogeneous disease and symptoms in each patient are different. We will determine which specific symptoms (obsessions, compulsions, depression and anxiety) map to which specific components of the network. This will pave the way to personalize DBS and to define symptom-specific targets tailored to individual patients. Third, while most of our preliminary research is based on normative connectome atlases of the human brain, connectomes of patients with OCD present with individual differences. We will test how much additional variance in clinical outcomes can be explained when using patient-specific instead of normative connectomes. Completion of these aims will validate and refine our OCD response network. If successful, this study will facilitate future trials directly targeting our brain circuit with DBS for OCD.

项目总结：研究强迫症的脑深部连接组刺激

项目成果

Association of clinical outcomes and connectivity in awake versus asleep deep brain stimulation for Parkinson disease.

• DOI: 10.3171/2022.6.jns212904
• 发表时间: 2023-04-01
• 期刊: JOURNAL OF NEUROSURGERY
• 影响因子: 4.1
• 作者: Gadot, Ron;Arroyave, Nora Vanegas;Dang, Huy;Anand, Adrish;Najera, Ricardo A.;Taneff, Lisa Yutong;Bellows, Steven;Tarakad, Arjun;Jankovic, Joseph;Horn, Andreas;Shofty, Ben;Viswanathan, Ashwin;Sheth, Sameer A.
• 通讯作者: Sheth, Sameer A.

Tractography-Based Modeling Explains Treatment Outcomes in Patients Undergoing Deep Brain Stimulation for Obsessive-Compulsive Disorder.

基于纤维束成像的模型解释了接受深部脑刺激治疗强迫症的患者的治疗结果。

• DOI: 10.1016/j.biopsych.2023.01.017
• 发表时间: 2023
• 期刊: Biological psychiatry
• 影响因子: 10.6
• 作者: Gadot,Ron;Li,Ningfei;Shofty,Ben;Avendano-Ortega,Michelle;McKay,Sarah;Bijanki,KellyR;Robinson,MeghanE;Banks,Garrett;Provenza,Nicole;Storch,EricA;Goodman,WayneK;Horn,Andreas;Sheth,SameerA
• 通讯作者: Sheth,SameerA

Advances in Technical Aspects of Deep Brain Stimulation Surgery.

• DOI: 10.1159/000529040
• 发表时间: 2023
• 期刊: STEREOTACTIC AND FUNCTIONAL NEUROSURGERY
• 影响因子: 1.7
• 作者: Schulder, Michael;Mishra, Akash;Mammis, Antonios;Horn, Andres;Boutet, Alexandre;Blomstedt, Patric;Chabardes, Stephan;Flouty, Oliver;Lozano, Andres M.;Neimat, Joseph S.;Ponce, Francisco;Starr, Philip A. A.;Krauss, Joachim K. K.;Hariz, Marwan;Chang, Jin Woo
• 通讯作者: Chang, Jin Woo