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Targeted electrode-based modulation of neural circuits for depression
Helen S. Mayberg
Helen S. Mayberg
Published April 1, 2009
Citation Information: J Clin Invest. 2009;119(4):717-725. https://doi.org/10.1172/JCI38454.
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Targeted electrode-based modulation of neural circuits for depression

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Abstract

During the last 20 years of neuroscience research, we have witnessed a fundamental shift in the conceptualization of psychiatric disorders, with the dominant psychological and neurochemical theories of the past now complemented by a growing emphasis on developmental, genetic, molecular, and brain circuit models. Facilitating this evolving paradigm shift has been the growing contribution of functional neuroimaging, which provides a versatile platform to characterize brain circuit dysfunction underlying specific syndromes as well as changes associated with their successful treatment. Discussed here are converging imaging findings that established a rationale for testing a targeted neuromodulation strategy, deep brain stimulation, for treatment-resistant major depression.

Authors

Helen S. Mayberg

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Figure 5

Circuit model of MDD.

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Circuit model of MDD.
Regions with known anatomical interconnections tha...
Regions with known anatomical interconnections that show consistent changes across converging imaging experiments form the basis of this model. Regions are grouped into four main compartments, reflecting general behavioral dimensions of MDD and regional targets of various antidepressant treatments. Regions within a compartment all have strong anatomical connections to one another. Black arrows identify cross-compartment anatomical connections. Solid colored arrows identify putative connections between compartments mediating a specific treatment: green indicates CBT; blue indicates pharmacotherapy; red indicates SCC DBS. a-ins, anterior insula; amg, amygdala; dm-Th, dorsomedial thalamus; dp-Hc, dorsal-posterior hippocampus; mb-vta, midbrain-ventral tegmental area; mF10/9, medial frontal cortex BA10 and BA9; mOF11, medial orbital frontal cortex BA11; Par40, parietal cortex BA40; PF46/9, prefrontal cortex BA46 and BA9; PM6, premotor cortex BA6; va-HC, ventral-anterior hippocampus; vst-cd, ventral striatum-caudate.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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