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Rozell, C.

Publications and source records attributed to Rozell, C..

3 recordsLinked to original sources

Ephaptic coupling and power fluctuations in depression

The initial therapeutic exposure to DBS during implantation surgery has reproducible acute behavioral effects that carry over without further stimulation. We analyzed LFP data from the first month following brief therapeutic intraoperative DBS. Data were recorded from the subcallosal cingulate cortex (SCC). During this month no further stimulation was applied. Recent studies have identified beta power fluctuations in LFP data as an acute putative depression biomarker of this exposure. However, a detailed description of neural dynamics underlying brain power fluctuations is missing. Here, we consider how these fluctuations are related to brain itinerancy, that is neural activity changes between stable and unstable states. We also provide a proof of principle study that these dynamics can be described using two new dynamical systems measures: instability frequency and relative wandering time. These capture interactions between neural activity and the mesoscale oscillatory electric fields generated by it. The two measures seem to split low vs. high HDRS scores within a small patient cohort. They are motivated by the cytoelectric coupling hypothesis, that suggests that efficient information processing results from mesoscale electric fields; and that the re-emergence of depression symptoms might result from altered electric fields. Whether the new measures reflect general mechanisms of rapid antidepressant action remains to be tested.

neuroscience↗

Neural Interoceptive Processing is Modulated by Deep Brain Stimulation for Treatment Resistant Depression

BackgroundA critical advance in depression research is to clarify the hypothesized role of interoceptive processing in neural mechanisms of treatment efficacy. This study tests whether cortical interoceptive processing, as indexed by the heartbeat-evoked potential (HEP), is modulated by deep brain stimulation (DBS) to the subcallosal cingulate (SCC) for treatment resistant depression (TRD). MethodsEight patients with TRD were enrolled in a study of SCC DBS safety and efficacy. Electroencephalography (EEG) and symptom severity measures were sampled in a laboratory setting over the course of a six-month treatment protocol. The primary outcome measure was an EEG-derived HEP, which reflects cortical processing of heartbeat sensation. Cluster-based permutation analyses were used to test the effect of stimulation and time in treatment on the HEP. The change in signal magnitude after treatment was correlated with change in depression severity as measured by the 17-item Hamilton Depression Rating Scale. ResultsHEP amplitude was greater after 24 weeks of treatment (t(7)=-4.40, p=.003, g=-1.38, 95% Cl [-2.3, -0.42]), and this change was inversely correlated with latency of treatment response (rho = -0.75, 95% Cl [-0.95, -0.11], p=.03). An acute effect of DBS was also observed, but as a decrease in HEP amplitude (t(6) =6.66, p<.001, g=2.19, 95% Cl [0.81, 3.54]). HEP differences were most pronounced over left posterior sensors from 405-425 ms post-stimulus. ConclusionBrain-based evidence substantiates a theorized link between interoception and depression, and suggests an interoceptive contribution to the mechanism of treatment efficacy with deep brain stimulation for severe depression.

neuroscience↗

Decoding Depression During Subcallosal Cingulate Deep Brain Stimulation

AO_SCPLOWBSTRACTC_SCPLOWDeep brain stimulation of subcallosal cingulate white matter (SCCwm-DBS) alleviates symptoms of treatment resistant depression (TRD) over months of therapy. Readouts of depression symptom severity derived from neural recordings are needed for more systematic study and improvement of the therapy. In this study, we measured local field potentials (LFP) multiple times a day alongside seven months of therapy using the Activa PC+S in six patients treated with SCCwm-DBS. We found significant changes in oscillatory power between early and late therapy after accounting for stimulation-related distortions, particularly within the {beta} band. We then used a decoder strategy to identify oscillatory activity that tracked with depression measurements over seven months, with asymmetric{delta} and {beta} oscillations contributing to a statistically significant prediction of 10% of the measured depression signal. Simulating its use in clinical decision-making, we demonstrated that the DR-SCC yield clinically meaningful information that can augment other measures of depression state. Ultimately, this DR-SCC provides a data-driven first-step towards objectively tracking chronic recovery after antidepressant DBS implantation and developing adaptive DBS strategies in the presence of active stimulation.

neuroscience↗