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Scans Show Secret To Brain Stimulation Success

April 30, 2014
Written by: , Filed in: Neuroradiology
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Deep brain stimulation (DBS) has helped some patients whose depression resisted other treatments. Others haven’t responded. Brain scans now indicate that precise placement of the stimulation electrodes is crucial—but not the whole story.

A new study used two imaging modalities: CT to pinpoint the location of the electrodes and MRI (diffusion tensor imaging) to precisely map white matter connections to the subcallosal cingulate (SCC)—the part of the brain that DBS targets. Helen Mayberg, MD, senior author of the study, explained the findings:

Precisely delineating these white matter connections appears to be very important to a successful outcome with this procedure. From a practical point of view, these results may help us to choose the optimal contact for stimulation and eventually to better plan the surgical placement of the DBS electrodes.

Dr. Mayberg is professor of psychiatry, neurology, and radiology at Emory University School of Medicine in Atlanta. She is also the Dorothy C. Fuqua Chair in Psychiatric Imaging and Therapeutics. She was quoted in an Emory news release. The study was published online earlier this month in Biological Psychiatry.

The study involved 16 patients with treatment-resistant depression who received subcallosal cingulate deep brain stimulation. After six months, six of the patients had responded positively. By two years after the beginning of DBS, an additional six patients had responded positively.

Scans of all 12 patients who improved showed common involvement of white matter connections between the SCC and the cingulum, the forceps minor, and the uncinate fasciculus. All of those who didn’t respond showed incomplete involvement of those connections.

“The new information will allow us to develop a refined algorithm for guiding surgical implantation of electrodes and optimizing the response through fine-tuning of stimulation paramaters,” Dr. Mayberg said. “That said, improving anatomical precision alone doesn’t account for all nonresponders, so that is an important next focus of our research.”

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Related CME seminar (up to 21 AMA PRA Category 1 credits™): UCSF Neuro and Musculoskeletal Imaging

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One Response to “Scans Show Secret To Brain Stimulation Success”

  1. Scans Show Secret To Brain Stimulation Success - Radiology Daily | welcome to radiologysecrets.comwelcome to radiologysecrets.com on April 30th, 2014 at 2:57 pm

    […] See more here: Scans Show Secret To Brain Stimulation Success – Radiology Daily […]