Deep brain stimulation for depression informed by intracranial recordings

Abstract The success of deep brain stimulation (DBS) for treating Parkinson’s disease has led to its application to several other disorders, including treatment-resistant depression (TRD). Results with DBS for TRD have been heterogeneous, with inconsistencies largely driven by incomplete understanding of the brain networks regulating mood, especially on an individual basis. We report results from the first subject treated with DBS for TRD using an approach that incorporates intracranial recordings to personalize understanding of network behavior and its response to stimulation. These recordings enabled calculation of individually optimized DBS stimulation parameters using a novel “inverse solution” approach. In the ensuing double-blind randomized phase incorporating these bespoke parameter sets, DBS led to remission of symptoms and dramatic improvement in quality of life. Results from this initial case demonstrate the feasibility of this personalized platform, which may be used to improve surgical neuromodulation for a vast array of neurological and psychiatric disorders.