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
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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.
Sellers, K. K., Khambhati, A. N., Stapper, N., Fan, J. M., Rao, V. R., Scangos, K. W., Chang, E. F., Krystal, A. D. Closed-Loop Neurostimulation for Biomarker-Driven, Personalized Treatment of Major Depressive Disorder. J. Vis. Exp. (197), e65177, doi:10.3791/65177 (2023).