Current perspectives on tractography-guided deep brain stimulation for the treatment of mood disorders.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY Expert Review of Neurotherapeutics Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI:10.1080/14737175.2023.2289573

Jason L Chan, Ariane V Carpentier, Erik H Middlebrooks, Michael S Okun, Joshua K Wong

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Abstract

Introduction: Deep brain stimulation (DBS) is an emerging therapy for mood disorders, particularly treatment-resistant depression (TRD). Different brain areas implicated in depression-related brain networks have been investigated as DBS targets and variable clinical outcomes highlight the importance of target identification. Tractography has provided insight into how DBS modulates disorder-related brain networks and is being increasingly used to guide DBS for psychiatric disorders.

Areas covered: In this perspective, an overview of the current state of DBS for TRD and the principles of tractography is provided. Next, a comprehensive review of DBS targets is presented with a focus on tractography. Finally, the challenges and future directions of tractography-guided DBS are discussed.

Expert opinion: Tractography-guided DBS is a promising tool for improving DBS outcomes for mood disorders. Tractography is particularly useful for targeting patient-specific white matter tracts that are not visible using conventional structural MRI. Developments in tractography methods will help refine DBS targeting for TRD and may facilitate symptom-specific precision neuromodulation. Ultimately, the standardization of tractography methods will be essential to transforming DBS into an established therapy for mood disorders.

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神经束造影引导下深部脑刺激治疗情绪障碍的现状。

脑深部电刺激(DBS)是一种新兴的情绪障碍治疗方法，特别是治疗难治性抑郁症(TRD)。与抑郁相关的脑网络的不同脑区已被研究作为DBS的靶点，不同的临床结果突出了靶点识别的重要性。神经束造影提供了关于DBS如何调节与疾病相关的大脑网络的见解，并越来越多地用于指导DBS治疗精神疾病。涵盖领域:从这个角度来看，提供了用于TRD的DBS的现状和牵道成像原理的概述。接下来，对DBS目标进行了全面的回顾，重点介绍了牵引术。最后，讨论了牵引图引导DBS技术面临的挑战和未来发展方向。专家意见:肌束造影引导的DBS是一种很有前途的工具，可以改善DBS治疗情绪障碍的结果。神经束造影对于针对患者特异性白质束特别有用，这些白质束在常规结构MRI中是看不见的。神经束造影方法的发展将有助于改进DBS对TRD的靶向治疗，并可能促进症状特异性的精确神经调节。最终，神经束造影方法的标准化对于将DBS转变为一种既定的情绪障碍治疗方法至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Neurotherapeutics Medicine-Neurology (clinical)

CiteScore

7.00

自引率

2.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points

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