Thomas Eduard Schlaepfer
University of Bonn, Germany
Title: Deep Brain Stimulation targets for Depression – On the way to personalized treatment?
Biography
Biography: Thomas Eduard Schlaepfer
Abstract
A core symptom of major depression is anhedonia (decreased drive and reward for pleasurable activities) and reduced motivation. The human reward system consists of the neural pathways involved in eliciting rewarding experiences in animals and humans its structures, the striatum (particularly the ventral striatum or nucleus accumbens (NAcc) and the medial forebrain bundle (MFB), are important in emotional memory, and might mediate those symptoms. Antidepressant effects of Deep Brain Stimulation (DBS) to the NAcc and two additional targets have been systematically assessed and results in response in 50-60% of patients studied, albeit only at relatively high stimulation intensities. Using probabilistic diffusion tensor imaging (DTI) we were able to demonstrate that all stimulation sites stimulate fibers of the MFB and hypothesized that DBS to the MFB closer to its origin in the ventral tegmental area might be associated with higher antidepressant efficacy at lower stimulation intensities since the extent of antianhedonic effect might be related to the recruited amount of fibers of the MFB. Recently we demonstrated unexpectedly rapid effects of this procedure.
