期刊
BRAIN STIMULATION
卷 8, 期 6, 页码 1033-1042出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.brs.2015.06.010
关键词
Deep brain stimulation; Subcallosal cingulate gyrus; Treatment resistant depression; Gamma oscillations; Theta-gamma coupling; Electroencephalography
资金
- Ontario Mental Health Foundation (OMHF)
- Canadian Institutes of Health Research (CIHR)
- Brain and Behaviour Research Foundation (NARSAD)
- Temerty Family
- Grant Family
- Centre for Addiction and Mental Health (CAMH) Foundation
- Campbell Institute
- University Health Network (UHN) Department of Psychiatry
- NARSAD
- National Institute of Health (NIH)
- Schizophrenia Society of Ontario
- St. Jude Medical
- AstraZeneca
- Boehringer Ingelheim
- Bristol Myers Squibb
- Clera
- Eli Lily
- GlaxoSmithKline
- Lundbeck
- Pfizer
- Spinaco
- Servier
- Neuronetics and Brainsway Inc
- Sepracor Inc
Background: Deep brain stimulation (DBS) in the subcallosal cingulate gyrus (SCG) is becoming an effective therapeutic option for treatment resistant depression (TRD). Objective/hypothesis: Identifying the neurophysiological mechanisms altered by DBS may lead to more tailored treatment parameters and enhanced efficacy. Methods: Twenty TRD patients with implanted DBS in the SCG were recruited. Patients participated in three EEG recording sessions, one with DBS ON, one with DBS randomized to ON or OFF, and one with DBS OFF. During each session, subjects performed N-back working memory tasks, namely the 0-back and 3-back. Fourteen subjects with valid EEG were included in the analysis. Changes in frontal gamma oscillations (30-50 Hz) and coupling between theta (4-7 Hz) and gamma oscillations as a result of DBS stimulation were quantified and correlated with depressive symptoms. Results: DBS stimulation resulted in suppression of frontal oscillations in the ON state relative to the OFF state during the N-back tasks. Greatest suppression was demonstrated in beta and gamma oscillations and most pronounced during the 3-back. Suppression of gamma oscillations in the 3-back correlated with a reduction in depressive symptoms. DBS ON relative to OFF in the 3-back also resulted in an increase in theta-gamma coupling that correlated with a reduction in depressive symptoms. Conclusion: Suppression of gamma oscillations and increased theta-gamma coupling through DBS is likely mediated by both SCG activation of inhibitory circuits and an enhancement of plasticity in the frontal cortex. Activation of both pathways may explain the therapeutic properties of DBS in TRD. (C) 2015 Elsevier Inc. All rights reserved.
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