Individualized targeting is warranted in subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression: A tractography analysis.


Journal

Human brain mapping
ISSN: 1097-0193
Titre abrégé: Hum Brain Mapp
Pays: United States
ID NLM: 9419065

Informations de publication

Date de publication:
01 08 2023
Historique:
revised: 27 04 2023
received: 08 08 2022
accepted: 01 05 2023
medline: 5 7 2023
pubmed: 25 5 2023
entrez: 25 5 2023
Statut: ppublish

Résumé

Subcallosal cingulate gyrus (SCG) is a target of deep brain stimulation (DBS) for treatment-resistant depression. However, previous randomized controlled trials report that approximately 42% of patients are responders to this therapy of last resort, and suboptimal targeting of SCG is a potential underlying factor to this unsatisfactory efficacy. Tractography has been proposed as a supplementary method to enhance targeting strategy. We performed a connectivity-based segmentation in the SCG region via probabilistic tractography in 100 healthy volunteers from the Human Connectome Project. The SCG voxels with maximum connectivity to brain regions implicated in depression, including Brodmann Area 10 (BA10), cingulate cortex, thalamus, and nucleus accumbens were identified, and the conjunctions were deemed as tractography-based targets. We then performed deterministic tractography using these targets in additional 100 volunteers to calculate streamline counts compassing to relevant brain regions and fibers. We also evaluated the intra- and inter-subject variance using test-retest dataset. Two tractography-based targets were identified. Tractography-based target-1 had the highest streamline counts to right BA10 and bilateral cingulate cortex, while tractography-based target-2 had the highest streamline counts to bilateral nucleus accumbens and uncinate fasciculus. The mean linear distance from individual tractography-based target to anatomy-based target was 3.2 ± 1.8 mm and 2.5 ± 1.4 mm in left and right hemispheres. The mean ± SD of targets between intra- and inter-subjects were 2.2 ± 1.2 and 2.9 ± 1.4 in left hemisphere, and 2.3 ± 1.4 and 3.1 ± 1.7 in right hemisphere, respectively. Individual heterogeneity as well as inherent variability from diffusion imaging should be taken into account during SCG-DBS target planning procedure.

Identifiants

pubmed: 37227015
doi: 10.1002/hbm.26339
pmc: PMC10318244
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

4200-4210

Subventions

Organisme : NIMH NIH HHS
ID : U54 MH091657
Pays : United States

Informations de copyright

© 2023 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.

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Auteurs

Zhoule Zhu (Z)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Jiawei Han (J)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

He Zhu (H)

Department of Ophthalmology and Vision Science, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China.

Chengwei Cai (C)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Chen Feng (C)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Xinxia Guo (X)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Yuqi Ying (Y)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Hongjie Jiang (H)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Zhe Zheng (Z)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Jianmin Zhang (J)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Junming Zhu (J)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

Hemmings Wu (H)

Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, China.

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