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Toward Patient-Specific Targeting and Parameter Setting of Deep Brain Stimulation for Relief of Depression

      The subcallosal cingulate cortex (SCC) is a target for deep brain stimulation (DBS) in efforts to help alleviate depression in patients for whom other treatments are ineffective. Riva-Posse et al. (
      • Riva-Posse P.
      • Choi K.S.
      • Holtzheimer P.E.
      • McIntyre C.C.
      • Gross R.E.
      • Chaturvedi A.
      • et al.
      Defining critical white matter pathways mediating successful subcallosal cingulate deep brain stimulation for treatment-resistant depression.
      ) combine preoperative magnetic resonance imaging and diffusion tensor imaging with postoperative imaging and probabilistic cartography in 17 patients who received SCC DBS and evaluate the efficacy of this approach to identify critical and patient-specific sites in the white matter. Responders, defined as patients whose condition improved after DBS, could be divided into two groups: At 6 months, 7 patients responded to stimulation and 10 did not. At 2 years, 6 more patients responded (total of 13 responders) and 2 did not. The authors provide imaging data at 6 months for 6 responders (1 responder did not have diffusion tensor imaging of adequate quality) and 10 nonresponders and at 2 years for 12 responders and 2 nonresponders. Two patients underwent explantation before 2 years.
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