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Closed-Loop Neurostimulation for Biomarker-Driven, Personalized Treatment of Major Depressive Disorder

2.0K Views

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05:19 min

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July 7th, 2023

DOI :

10.3791/65177-v

July 7th, 2023

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Kristin K. Sellers¹^,², Ankit N. Khambhati¹^,², Noah Stapper²^,³, Joline M. Fan²^,⁴, Vikram R. Rao²^,⁴, Katherine W. Scangos²^,³, Edward F. Chang¹^,², Andrew D. Krystal²^,³

¹Department of Neurological Surgery, University of California, San Francisco, ²Weill Institute for Neurosciences, University of California, San Francisco, ³Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, ⁴Department of Neurology, University of California, San Francisco

Transcript

We are assessing the therapeutic benefit of closed-loop personalized deep brain stimulation for the treatment of major depressive disorder. This protocol outlines how to identify a personalized neural biomarker that is correlated with symptom severity, and then program an implanted neurostimulator to administer stimulation using that biomarker. Prior applications of deep brain stimulation for depression used continuous stimulation, which was always on, regardless of symptom status.

This protocol describes using closed-loop stimulation in which we only deliver stimulation during high symptom states. Continued work to identify biomarkers for control of closed-loop stimulation will facilitate an approach where we can target the unique time courses of different symptoms.

Summary

Deep brain stimulation triggered by a patient-specific neural biomarker of a high-symptom state may better control symptoms of major depressive disorder compared to continuous, open-loop stimulation. This protocol provides a workflow for identifying a patient-specific neural biomarker and controlling the delivery of therapeutic stimulation based on the identified biomarker.

Explore More Videos

Closed loop Neurostimulation

Major Depressive Disorder

Personalized Treatment

Neural Biomarker

Deep Brain Stimulation

Symptom Severity

Implanted Neurostimulator

High symptom States

Therapeutic Benefit

Continuous Stimulation

Energy Consumption

Treatment refractory MDD

Neural Recordings

State space Model

Stimulation Therapy

Chapters in this video

0:00

Introduction

1:02

Neurostimulation System Setup and Symptom Collection for Patient At‐Home Recordings

2:35

Procedure for Concurrent At‐Home Symptom Reports and Neural Recordings

3:46

Programming Device Detector Settings for Closed‐Loop Neurostimulation

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