title: Using probabilistic tractography to target the subcallosal cingulate cortex in patients with treatment resistant depression.
abstract: The lack of efficacy of deep brain stimulation (DBS) of subcallosal cingulate (SCC) in treatment resistant depression (TRD) may be due in part to suboptimal targeting. In two patients treated with SCC DBS for TRD we assessed the voxel-wise probabilistic connectivity of SCC with four tractography-defined target areas implicated in depression, thereby identifying the tractography-optimized target (TOT). Compared to the non-responder, the responder's DBS leads were implanted and stimulation was delivered closer to the TOT. This automated patient-specific data-driven approach provides tomographic maps that could guide DBS targeting and programming with possible implications for improving response to DBS.
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: ETsolaki@mednet.ucla.edu.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Tsolaki
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: REspinoza@mednet.ucla.edu.
authors.forename: Randall
authors.initials: R
authors.lastname: Espinoza
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: NPouratian@mednet.ucla.edu.
authors.forename: Nader
authors.initials: N
authors.lastname: Pouratian
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation / Q000379:methods*; D061218:Depressive Disorder, Treatment-Resistant / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male
keywords: Deep brain stimulation; Depression; Probabilistic tractography