Distance to white matter trajectories is associated with treatment response to internal capsule deep brain stimulation in treatment-refractory depression
| Autor: | Guido van Wingen, Judy Luigjes, Bart de Kwaasteniet, Samuel J. Natarajan, P. Richard Schuurman, Isidoor O. Bergfeld, Damiaan Denys, Pepijn van den Munckhof, Luka C. Liebrand, Matthan W.A. Caan |
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| Přispěvatelé: | Netherlands Institute for Neuroscience (NIN), AMS - Amsterdam Movement Sciences, Biomedical Engineering and Physics, ACS - Microcirculation, ACS - Diabetes & metabolism, Graduate School, ACS - Atherosclerosis & ischemic syndromes, AMS - Restoration & Development, Neurosurgery, ANS - Systems & Network Neuroscience, Adult Psychiatry, APH - Methodology, APH - Aging & Later Life |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Internal capsule
medicine.medical_treatment Stimulation MDD major depressive disorder ALIC anterior limb of the internal capsule lcsh:RC346-429 slMFB superolateral medial forebrain bundle Depressive Disorder Treatment-Resistant 0302 clinical medicine PFC prefrontal cortex Internal Capsule Deep brain stimulation Medial forebrain bundle ATR anterior thalamic radiation NAc nucleus accumbens medicine.diagnostic_test ACC anterior cingulate cortex 05 social sciences Regular Article Anatomy White Matter CT computed tomography Diffusion Tensor Imaging medicine.anatomical_structure Neurology lcsh:R858-859.7 TRD treatment-refractory depression Tractography dMRI diffusion-weighted magnetic resonance imaging Cognitive Neuroscience VAT volume of activated tissue lcsh:Computer applications to medicine. Medical informatics VTA ventral tegmental area 050105 experimental psychology Diffusion MRI White matter 03 medical and health sciences OFC orbitofrontal cortex Anterior limb of the internal capsule medicine Humans 0501 psychology and cognitive sciences Radiology Nuclear Medicine and imaging OCD obsessive-compulsive disorder lcsh:Neurology. Diseases of the nervous system business.industry Magnetic resonance imaging HAM-D Hamilton depression rating scale Neurology (clinical) business DBS deep brain stimulation 030217 neurology & neurosurgery Treatment-refractory depression |
| Zdroj: | NeuroImage: Clinical, Vol 28, Iss, Pp 102363-(2020) NeuroImage : Clinical Neuroimage. Clinical, 28. Elsevier B.V. NeuroImage. Clinical, 28:102363. Elsevier BV |
| ISSN: | 2213-1582 |
| Popis: | Highlights • Stimulation closer to tracts was associated with better outcome in DBS for depression. • Lead placement was consistent across (non)responders w.r.t. anatomical landmarks. • Tractography-guided surgery needed to ensure tracts lie within activated tissue. Background Deep brain stimulation (DBS) is an innovative treatment for treatment-refractory depression. DBS is usually targeted at specific anatomical landmarks, with patients responding to DBS in approximately 50% of cases. Attention has recently shifted to white matter tracts to explain DBS response, with initial open-label trials targeting white matter tracts yielding much higher response rates (>70%). Objective/Hypothesis Our aim was to associate distance to individual white matter tracts around the stimulation target in the ventral anterior limb of the internal capsule to treatment response. Methods We performed diffusion magnetic resonance tractography of the superolateral branch of the medial forebrain bundle and the anterior thalamic radiation in fourteen patients that participated in our randomized clinical trial. We combined the tract reconstructions with the postoperative images to identify the DBS leads and estimated the distance between tracts and leads, which we subsequently associated with treatment response. Results Stimulation closer to both tracts was significantly correlated to a larger symptom decrease (r = 0.61, p = 0.02), suggesting that stimulation more proximal to the tracts was beneficial. Biophysical modelling indicated that 37.5% of tracts were even outside the volume of activated tissue. There was no difference in lead placement with respect to anatomical landmarks, which could mean that differences in treatment response were driven by individual differences in white matter anatomy. Conclusions Our results suggest that deep brain stimulation of the ventral anterior limb of the internal capsule could benefit from targeting white matter bundles. We recommend acquiring diffusion magnetic resonance data for each individual patient. |
| Databáze: | OpenAIRE |
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