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Different patterns of local field potentials from limbic DBS targets in patients with major depressive and obsessive compulsive disorder

Molecular Psychiatry volume 19, pages 1186–1192 (2014)Cite this article

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Abstract

The role of distinct limbic areas in emotion regulation has been largely inferred from neuroimaging studies. Recently, the opportunity for intracranial recordings from limbic areas has arisen in patients undergoing deep brain stimulation (DBS) for neuropsychiatric disorders including major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Here we test the hypothesis that distinct temporal patterns of local field potential (LFP) activity in the human limbic system reflect disease state and symptom severity in MDD and OCD patients. To this end, we recorded LFPs via implanted DBS electrodes from the bed nucleus of stria terminalis (BNST area) in 12 patients (5 OCD, 7 MDD) and from the subgenual cingulate cortex in 7 MDD patients (CG25 area). We found a distinct pattern of oscillatory activity with significantly higher α-power in MDD compared with OCD in the BNST area (broad α-band 8–14 Hz; P<0.01) and a similar level of α-activity in the CG25 area as in the BNST area in MDD patients. The mean α-power correlated with severity of depressive symptoms as assessed by the Beck depression inventory in MDD (n=14, r=0.55, P=0.042) but not with severity of obsessive compulsive symptoms in OCD. Here we show larger α-band activity in MDD patients compared with OCD recorded from intracranial DBS targets. Our results suggest that α-activity in the limbic system may be a signature of symptom severity in MDD and may serve as a potential state biomarker for closed loop DBS in MDD.

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Acknowledgements

This work was supported by the German Research Foundation (DFG, grant KFO 247). We thank Jens Kuhn and Sabine Aust for help with some of the patients operated in Berlin. Medtronic provided all implanted material for free for all patients.

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Authors and Affiliations

  1. Department of Neurology, Charité–University Medicine Berlin, Berlin, Germany,

    W-J Neumann, J Huebl, C Brücke, A Merkl & A A Kühn

  2. Department of Psychiatry, University Hospital Leuven, Leuven, Belgium,

    L Gabriëls

  3. Department of Psychiatry and Psychotherapy, Charité–University Medicine Berlin, Berlin, Germany,

    M Bajbouj & A Merkl

  4. Department of Neurosurgery, Charité–University Medicine Berlin, Berlin, Germany,

    G-H Schneider

  5. Department of Neurosurgery, University Hospital Leuven, Leuven, Belgium,

    B Nuttin

  6. Nuffield Department of Clinical Neurosciences, University of Oxford, and National Institute of Health Related Research Oxford Biomedical Research Centre, Oxford, UK,

    P Brown

  7. Berlin School of Mind and Brain, Charité–University Medicine Berlin, Berlin, Germany

    A A Kühn

  8. NeuroCure, Charité–University Medicine Berlin, Berlin, Germany,

    A A Kühn

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  1. W-J Neumann
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Disclosure

WJN received travel grants from St Jude medical. JH received speaker’s honoraria from Merz Pharmaceuticals. BN and LG hold a chair ‘Neurosurgery for psychiatric disorders’, a donation from Medtronic. BN received grants for travel, research and education from Medtronic. PB received honoraries from Medtronic and Sapiens. AAK received honoraries from Medtronic, St Jude Medical, Boston Scientific, Novartis, Bayer AG and support for travel to conferences by Ipsen Pharma.

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Neumann, WJ., Huebl, J., Brücke, C. et al. Different patterns of local field potentials from limbic DBS targets in patients with major depressive and obsessive compulsive disorder. Mol Psychiatry 19, 1186–1192 (2014). https://doi.org/10.1038/mp.2014.2

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Keywords

  • alpha oscillations
  • deep brain stimulation
  • depressive disorder
  • local field potential
  • obsessive compulsive disorder

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