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Abstract #0174

Treatment, Neuromodulation

Helen S. Mayberg1

1Emory University, Atlanta, GA, United States

Critical to the refinement of subcallosal cingulate DBS as a therapeutic strategy for patients with intractable depression will be the full characterization of brain systems mediating abnormal mood states as well as those mediating successful and unsuccessful response. Functional neuroimaging first provided the critical foundation for target selection in initial pilot studies. Imaging has further played an important role in quantifying physiological effects of chronic stimulation, with emerging evidence of differential patterns in responders and non-responders. As clinical studies proceed, development of reliable biomarkers to improve patient recruitment, enhance surgical targeting and optimize parameter selection will be a necessary next step.

Keywords

abnormal abnormalities accompany activity acute adjacent adopting antidepressant arch berg better blood brain cellular cerebral characterization characterize chronic chronically circuit circuits clinical combined complemented conceptualization connected continues contribution converging cortex critical decreases deep demonstrating depressed depression development developmental directly disorders dominant downstream dysfunction elevated emphasis enhance established evolving example extended facilitating flow foundation full fully functional fundamental genetic growing hypothesized identify improve increasingly induced initial intractable last maintaining major measures mediate mediating metabolism models molecular mood necessary negative network neuron ongoing opportunity optimization optimize outcome paradigm past patient patients patterns physiological plausible post potential predict predictable proceed proving psych psychiatric psychological published putative quantify randomized rationale realize recruitment reduce regional reliable resistant responding response robust role scale scanning selection stimulation strategies strategy structural studies successful sufficient surgical sustained system systematic target targeted targeting targets theories tracts treatment treatments trials understanding unique unsuccessful useful utility various white witnessed years