Habenular Involvement in Response to Subcallosal Cingulate Deep Brain Stimulation for Depression

The habenula (Hb) is a small, evolutionarily conserved epithalamic structure implicated in functions such as reward and mood regulation. Prior imaging work suggests that Hb's structural and functional properties may relate to treatment response in depression and other mood disorders. We used mu...

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Bibliographic Details
Published in:Frontiers in psychiatry 2022-02, Vol.13, p.810777-810777
Main Authors: Elias, Gavin J B, Germann, Jürgen, Loh, Aaron, Boutet, Alexandre, Pancholi, Aditya, Beyn, Michelle E, Bhat, Venkat, Woodside, D Blake, Giacobbe, Peter, Kennedy, Sidney H, Lozano, Andres M
Format: Article
Language:English
Subjects:
deep brain stimulation
depression
habenula
neuroimaging
neuromodulation
Psychiatry
treatment biomarker
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Summary:The habenula (Hb) is a small, evolutionarily conserved epithalamic structure implicated in functions such as reward and mood regulation. Prior imaging work suggests that Hb's structural and functional properties may relate to treatment response in depression and other mood disorders. We used multimodal MRI techniques to investigate the potential involvement of Hb in response to subcallosal cingulate area deep brain stimulation (SCC-DBS) for treatment-resistant mood disorders. Using an automated segmentation technique, we compared Hb volume at baseline and at a subsequent post-operative timepoint (4.4 ± 3.0 years after surgery) in a cohort of 32 patients who received SCC-DBS. Clinical response to treatment (≥50% decrease in HAMD-17 from baseline to 12 months post-operation) was significantly associated with longitudinal Hb volume change: responders tended to have increased Hb volume over time, while non-responders showed decreased Hb volume ( = 2.4, = 0.021). We additionally used functional MRI (fMRI) in a subcohort of SCC-DBS patients ( = 12) to investigate immediate within-patient changes in Hb functional connectivity associated with SCC-DBS stimulation. Active DBS was significantly associated with increased Hb connectivity to several prefrontal and corticolimbic regions (TFCE-adjusted < 0.0001), many of which have been previously implicated in the neurocircuitry of depression. Taken together, our results suggest that Hb may play an important role in the antidepressant effect of SCC-DBS.
ISSN:1664-0640
1664-0640
DOI:10.3389/fpsyt.2022.810777