Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
Neuroimage. 2013 Oct 1;79:30-41. doi: 10.1016/j.neuroimage.2013.04.065. Epub 2013 Apr 28.
From a neuroimaging point of view, deep brain stimulation (DBS) in psychiatric disorders represents a unique source of information to probe results gained in functional, structural and molecular neuroimaging studies in vivo. However, the implementation has, up to now, been restricted by the heterogeneity of the data reported in DBS studies. The aim of the present study was therefore to provide a comprehensive and standardized database of currently used DBS targets in selected psychiatric disorders (obsessive-compulsive disorder (OCD), treatment-resistant depression (TRD), Gilles de la Tourette syndrome (GTS)) to enable topological comparisons between neuroimaging results and stimulation areas. A systematic literature research was performed and all peer-reviewed publications until the year 2012 were included. Literature research yielded a total of 84 peer-reviewed studies including about 296 psychiatric patients. The individual stimulation data of 37 of these studies meeting the inclusion criteria which included a total of 202 patients (63 OCD, 89 TRD, 50 GTS) was translated into MNI stereotactic space with respect to AC origin in order to identify key targets. The created database can be used to compare DBS target areas in MNI stereotactic coordinates with: 1) activation patterns in functional brain imaging (fMRI, phfMRI, PET, MET, EEG); 2) brain connectivity data (e.g., MR-based DTI/tractography, functional and effective connectivity); 3) quantitative molecular distribution data (e.g., neuroreceptor PET, post-mortem neuroreceptor mapping); 4) structural data (e.g., VBM for neuroplastic changes). Vice versa, the structural, functional and molecular data may provide a rationale to define new DBS targets and adjust/fine-tune currently used targets in DBS based on this overview in stereotactic coordinates. Furthermore, the availability of DBS data in stereotactic space may facilitate the investigation and interpretation of treatment effects and side effect of DBS by comparing these to neuroimaging results. The present study thus improves comparability between functional, structural and molecular data in standard stereotactic space gained in neuroimaging studies with surgical targets for DBS, which is among other possible implications of crucial importance for the definition of new targets for effective DBS.
从神经影像学的角度来看，深部脑刺激（DBS）在精神疾病中的应用是一种独特的信息来源，可以深入探究在功能、结构和分子神经影像学活体研究中获得的结果。然而，到目前为止，这种方法的实施受到 DBS 研究中报告的数据异质性的限制。因此，本研究的目的是提供一个综合的、标准化的数据库，其中包含选定的精神疾病（强迫症（OCD）、难治性抑郁症（TRD）、 Gilles de la Tourette 综合征（GTS））中目前使用的 DBS 靶点，以实现神经影像学结果和刺激区域之间的拓扑比较。我们进行了系统的文献检索，纳入了截至 2012 年的所有同行评议的出版物。文献检索共产生了 84 项同行评议研究，包括约 296 名精神疾病患者。符合纳入标准的 37 项研究中的个体刺激数据，包括总共 202 名患者（63 名 OCD、89 名 TRD、50 名 GTS），被转换为以 AC 原点为参照的 MNI 立体空间，以确定关键靶点。创建的数据库可用于将 DBS 靶点区域与：1）功能脑成像（fMRI、phfMRI、PET、MET、EEG）中的激活模式；2）脑连接数据（例如，基于磁共振的 DTI/束追踪、功能和有效连接）；3）定量分子分布数据（例如，神经受体 PET、死后神经受体绘图）；4）结构数据（例如，神经可塑性变化的 VBM）进行比较。反之，结构、功能和分子数据可以为根据这个在立体定向坐标上的概述，定义新的 DBS 靶点和调整/微调目前使用的 DBS 靶点提供依据。此外，DBS 数据在立体定向空间中的可用性可以通过将其与神经影像学结果进行比较，来促进 DBS 治疗效果和副作用的研究和解释。本研究因此提高了神经影像学研究中获得的功能、结构和分子数据与 DBS 手术靶点之间的可比性，这对有效 DBS 新靶点的定义具有至关重要的影响。
