Closed-Loop Neurostimulation for Biomarker-Driven, Personalized Treatment of Major Depressive Disorder

Kristin K. Sellers; Ankit N. Khambhati; Noah Stapper; Joline M. Fan; Vikram R. Rao; Katherine W. Scangos; Edward F. Chang; Andrew D. Krystal

doi:10.3791/65177

Journal

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Neuroscience

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Closed-Loop Neurostimulation for Biomarker-Driven, Personalized Treatment of Major Depressive Disorder

JoVE Journal
Neuroscience

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JoVE Journal Neuroscience

Closed-Loop Neurostimulation for Biomarker-Driven, Personalized Treatment of Major Depressive Disorder

2,337 Views

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05:19 min

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July 07, 2023

DOI:

10.3791/65177-v

DOI:

10.3791/65177-v

•

05:19 min

July 07, 2023

•

2276 Views

Kristin K. Sellers^1,2, Ankit N. Khambhati^1,2, Noah Stapper^2,3, Joline M. Fan^2,4, Vikram R. Rao^2,4, Katherine W. Scangos^2,3, Edward F. Chang^1,2, Andrew D. Krystal^2,3

¹Department of Neurological Surgery,University of California, San Francisco ²Weill Institute for Neurosciences,University of California, San Francisco ³Department of Psychiatry and Behavioral Sciences,University of California, San Francisco ⁴Department of Neurology,University of California, San Francisco

Transcript

We are assessing the therapeutic benefit of closed-loop personalized deep brain stimulation for the treatment of major depressive disorder. This protocol outlines how to identify a personalized neural biomarker that is correlated with symptom severity, and then program an implanted neurostimulator to administer stimulation using that biomarker. Prior applications of deep brain stimulation for depression used continuous stimulation, which was always on, regardless of symptom status.

This protocol describes using closed-loop stimulation in which we only deliver stimulation during high symptom states. Continued work to identify biomarkers for control of closed-loop stimulation will facilitate an approach where we can target the unique time courses of different symptoms.

Summary

Deep brain stimulation triggered by a patient-specific neural biomarker of a high-symptom state may better control symptoms of major depressive disorder compared to continuous, open-loop stimulation. This protocol provides a workflow for identifying a patient-specific neural biomarker and controlling the delivery of therapeutic stimulation based on the identified biomarker.