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Author Notes:

Address reprint requests to David A. Gutman, M.D., Ph.D., Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 101 Woodruff Circle, Suite 4000 WMRB, Atlanta, GA 30322; dgutman@emory.edu.

HSM consults to Advanced Neuromodulation Systems (ANS; a division of St. Jude Medical) and has intellectual property rights on deep brain stimulation technology for treating depression that have been licensed to ANS.

PEH consults to ANS, Tetragenex, Inc., and AstraZeneca, Inc. DAG, TEJB, and HJ-B have reported no biomedical financial interests or potential conflicts of interest.

Subjects:

Research Funding:

This work was supported by the United Kingdom Medical Research Council (TEJB), the Wellcome Trust (HJ-B), the Stanley Medical Research Institute (HSM), the Dana Foundation (HSM), the Woodruff Fund (HSM), a NARSAD Young Investigator Award (PEH), and K23 MH077869 (PEH).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Neurosciences
  • Psychiatry
  • Neurosciences & Neurology
  • DBS
  • deep brain stimulation
  • depression
  • diffusion tensor imaging
  • DTI
  • internal capsule
  • subgenual cingulate
  • tractography
  • MEDIAL PREFRONTAL CORTEX
  • TREATMENT-RESISTANT DEPRESSION
  • PROBABILISTIC DIFFUSION TRACTOGRAPHY
  • OBSESSIVE-COMPULSIVE DISORDER
  • POSITRON-EMISSION-TOMOGRAPHY
  • MAJOR DEPRESSION
  • MACAQUE MONKEYS
  • CORTICAL PROJECTIONS
  • PERIAQUEDUCTAL GRAY
  • WATER DIFFUSION

A Tractography Analysis of Two Deep Brain Stimulation White Matter Targets for Depression

Tools:

Journal Title:

Biological Psychiatry

Volume:

Volume 65, Number 4

Publisher:

, Pages 276-282

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: Deep brain stimulation (DBS) of the subcallosal cingulate white matter (SCCwm) or anterior limb of the internal capsule (ALIC) may be effective in treating depression. Connectivity patterns of these regions may inform on mechanisms of action for DBS of these targets. Methods: Diffusion tensor imaging (DTI) and probabilistic tractography were performed in 13 nondepressed subjects to determine connectivity patterns of SCCwm and ALIC. Tract maps were generated for each target in each subject, and tract voxels were coded as being unique to either target or shared. Group level tract maps were generated by including only those voxels common to at least 10 of 13 (>75%) subjects. Results: The two targets have distinct patterns of connectivity with regions of overlap. The SCCwm showed consistent ipsilateral connections to the medial frontal cortex, the full extent of the anterior and posterior cingulate, medial temporal lobe, dorsal medial thalamus, hypothalamus, nucleus accumbens, and the dorsal brainstem. The ALIC seed, in contrast, demonstrated widespread projections to frontal pole, medial temporal lobe, cerebellum, nucleus accumbens, thalamus, hypothalamus, and brainstem. Common to both targets, albeit through distinct white matter bundles, were connections to frontal pole, medial temporal lobe, nucleus accumbens, dorsal thalamus, and hypothalamus. Conclusions: Connectivity patterns of these two DBS white matter targets suggest distinct neural networks with areas of overlap in regions implicated in depression and antidepressant response.

Copyright information:

© 2009 Society of Biological Psychiatry.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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