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Record W4386886562 · doi:10.1038/s41586-023-06541-3

Cingulate dynamics track depression recovery with deep brain stimulation

2023· article· en· W4386886562 on OpenAlexaff
Sankaraleengam Alagapan, Ki Sueng Choi, Stephen Heisig, Patricio Riva‐Posse, Andrea Crowell, Vineet Tiruvadi, Mosadoluwa Obatusin, Ashan Veerakumar, Allison C. Waters, Robert E. Gross, Sinéad Quinn, Lydia Denison, Matthew O’Shaughnessy, Marissa Connor, Gregory Canal, Jungho Cha, Rachel Hershenberg, Tanya Nauvel, Faiçal Isbaine, Muhammad Furqan Afzal, Martijn Figee, Brian H. Kopell, Robert J. Butera, Helen S. Mayberg, Christopher J. Rozell

Bibliographic record

VenueNature · 2023
Typearticle
Languageen
FieldMedicine
TopicNeurological disorders and treatments
Canadian institutionsWestern University
FundersNational Center for Advancing Translational SciencesNational Institute of Arthritis and Musculoskeletal and Skin DiseasesNational Institute of Neurological Disorders and StrokeNational Institute of Mental HealthNational Institute on AgingGeorgia Institute of TechnologyNational Institutes of HealthNational Science FoundationJames S. McDonnell FoundationUniversity of GeorgiaUniversity of OxfordHope for Depression Research Foundation
KeywordsDeep brain stimulationTreatment-resistant depressionMoodNeuroscienceDepression (economics)White matterMedicineBrain stimulationClinical trialNeuroimagingBiomarkerPsychologyMajor depressive disorderPhysical medicine and rehabilitationStimulationMagnetic resonance imagingPsychiatryInternal medicineDiseaseBiologyRadiology

Abstract

fetched live from OpenAlex

Abstract Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) can provide long-term symptom relief for treatment-resistant depression (TRD)1. However, achieving stable recovery is unpredictable2, typically requiring trial-and-error stimulation adjustments due to individual recovery trajectories and subjective symptom reporting3. We currently lack objective brain-based biomarkers to guide clinical decisions by distinguishing natural transient mood fluctuations from situations requiring intervention. To address this gap, we used a new device enabling electrophysiology recording to deliver SCC DBS to ten TRD participants (ClinicalTrials.gov identifier NCT01984710). At the study endpoint of 24 weeks, 90% of participants demonstrated robust clinical response, and 70% achieved remission. Using SCC local field potentials available from six participants, we deployed an explainable artificial intelligence approach to identify SCC local field potential changes indicating the patient’s current clinical state. This biomarker is distinct from transient stimulation effects, sensitive to therapeutic adjustments and accurate at capturing individual recovery states. Variable recovery trajectories are predicted by the degree of preoperative damage to the structural integrity and functional connectivity within the targeted white matter treatment network, and are matched by objective facial expression changes detected using data-driven video analysis. Our results demonstrate the utility of objective biomarkers in the management of personalized SCC DBS and provide new insight into the relationship between multifaceted (functional, anatomical and behavioural) features of TRD pathology, motivating further research into causes of variability in depression treatment.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.001
Threshold uncertainty score0.004

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.008
GPT teacher head0.274
Teacher spread0.266 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations263
Published2023
Admission routes1
Has abstractyes

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