Poster No:
8
Submission Type:
Abstract Submission
Authors:
Davide Momi1, Andrew Smith2, Elisa Xu3, Sonya Olson3, Zarghona Imtiaz3, Samantha Pitts3, Jip de Bruin3, Helen Mayberg3, Brian Kopell3, Ki Sueng Choi3, Martijn Figee3, Allison Waters3
Institutions:
1CAMH, Toronto, Ontario, 2Icahn School of Medicine At Mount Sinai, New York, NY, 3Icahn School of Medicine at Mount Sinai, New York, NY
First Author:
Co-Author(s):
Andrew Smith
Icahn School of Medicine At Mount Sinai
New York, NY
Elisa Xu
Icahn School of Medicine at Mount Sinai
New York, NY
Sonya Olson
Icahn School of Medicine at Mount Sinai
New York, NY
Jip de Bruin
Icahn School of Medicine at Mount Sinai
New York, NY
Helen Mayberg
Icahn School of Medicine at Mount Sinai
New York, NY
Brian Kopell
Icahn School of Medicine at Mount Sinai
New York, NY
Ki Sueng Choi
Icahn School of Medicine at Mount Sinai
New York, NY
Martijn Figee
Icahn School of Medicine at Mount Sinai
New York, NY
Introduction:
Obsessive-compulsive disorder (OCD) is a debilitating condition, affecting approximately 2.3% of individuals throughout their lifetime (Ruscio et al., 2010). The US FDA allows treatment of severe cases using deep brain stimulation (DBS) to the anterior limb of the internal capsule (ALIC) under an Humanitarian Device Exemption (Anderson and Ahmed, 2003). DBS has demonstrated efficacy in providing relief from symptoms. However, the journey to stable recovery remains unpredictable, often necessitating trial-and-error adjustments in stimulation. This variability is attributed to individual differences in the neural response to stimulation and uncertainty about surgical target engagement. Subjective symptom reporting is not sufficient for rapid parameter optimization, necessitating the development of objective, brain-based biomarkers to confirm optimal DBS target engagement.
Methods:
We recorded high density electroencephalography (hd-EEG, 256-array) in nine OCD patients during 2 Hz stimulation to the anterior limb of the internal capsule (ALIC). Cortical evoked responses, time-locked to the DBS pulse, were captured for each electrode contact within the target region, amounting to eight total conditions (four per hemisphere). The clinically optimal contact in each hemisphere was identified prior to surgery using diffusion weighted MRI tractography. The reliability of the stimulus evoked propagation patterns was examined for every individual and for every stimulation condition. Global Mean Field Power (GMFP) was extracted from every condition, and used to calculate the Area Under the Curve (AUC). We hypothesized that stimulation delivered to the tractography-defined optimal target would result in greater AUC activation.
Results:
Results showed that stimulation in the ALIC generates stable and reproducible cortical responses within individuals, with some elements of the cortical response also being consistent between individuals. Moreover we found a significantly stronger propagation pattern when the stimulation was delivered to the tractographically defined target, both for early (0-80ms) and late (130-150ms) responses.
Conclusions:
Overall, these novel discoveries pinpoint the potential usage of the cortical evoked potential as a brain-based biomarker of DBS target engagement. These findings have implications for understanding brain function, and potential applications for personalizing therapeutic interventions.
Brain Stimulation:
Deep Brain Stimulation 1
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 2
Modeling and Analysis Methods:
Connectivity (eg. functional, effective, structural)
Diffusion MRI Modeling and Analysis
EEG/MEG Modeling and Analysis
Keywords:
ELECTROCORTICOGRAPHY
Electroencephaolography (EEG)
ELECTROPHYSIOLOGY
MRI
Obessive Compulsive Disorder
Psychiatric
Psychiatric Disorders
STRUCTURAL MRI
Tractography
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
1|2Indicates the priority used for review
Provide references using author date format
Anderson, D., Ahmed, A., 2003. Treatment of patients with intractable obsessive-compulsive disorder with anterior capsular stimulation. Case report. J Neurosurg 98, 1104–1108. https://doi.org/10.3171/jns.2003.98.5.1104
Ruscio, A.M., Stein, D.J., Chiu, W.T., Kessler, R.C., 2010. The Epidemiology of Obsessive-Compulsive Disorder in the National Comorbidity Survey Replication. Molecular psychiatry 15, 53. https://doi.org/10.1038/mp.2008.94