Smart Otis Lkuwamy, Tiruvadi Vineet Ravi, Mayberg Helen S
Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.
Department of Biomedical Engineering, Georgia Institute of Technology, Emory University School of Medicine, Atlanta, Georgia.
Biol Psychiatry. 2015 Jun 15;77(12):1061-70. doi: 10.1016/j.biopsych.2015.01.002. Epub 2015 Jan 28.
The renaissance in the use of encephalography-based research methods to probe the pathophysiology of neuropsychiatric disorders is well afoot and continues to advance. Building on the platform of neuroimaging evidence on brain circuit models, magnetoencephalography, scalp electroencephalography, and even invasive electroencephalography are now being used to characterize brain network dysfunctions that underlie major depressive disorder using brain oscillation measurements and associated treatment responses. Such multiple encephalography modalities provide avenues to study pathologic network dynamics with high temporal resolution and over long time courses, opportunities to complement neuroimaging methods and findings, and new approaches to identify quantitative biomarkers that indicate critical targets for brain therapy. Such goals have been facilitated by the ongoing testing of novel invasive neuromodulation therapies, notably, deep brain stimulation, where clinically relevant treatment effects can be monitored at multiple brain sites in a time-locked causal manner. We review key brain rhythms identified in major depressive disorder as foundation for development of putative biomarkers for objectively evaluating neuromodulation success and for guiding deep brain stimulation or other target-based neuromodulation strategies for treatment-resistant depression patients.
利用基于脑电描记术的研究方法来探究神经精神疾病病理生理学的复兴正在稳步推进且持续发展。基于脑回路模型的神经影像学证据这一平台，如今磁脑图、头皮脑电图，甚至侵入性脑电图正被用于通过脑振荡测量及相关治疗反应来表征重度抑郁症潜在的脑网络功能障碍。此类多种脑电描记术模态提供了以高时间分辨率和长时间进程来研究病理性网络动力学的途径、补充神经影像学方法及研究结果的机会，以及识别定量生物标志物的新方法，这些生物标志物可指示脑治疗的关键靶点。新型侵入性神经调节疗法，尤其是深部脑刺激的持续试验推动了此类目标的实现，在深部脑刺激中，可以时间锁定的因果方式在多个脑区监测临床相关的治疗效果。我们回顾了在重度抑郁症中识别出的关键脑节律，以此作为开发假定生物标志物的基础，用于客观评估神经调节的成功与否，并指导针对难治性抑郁症患者的深部脑刺激或其他基于靶点的神经调节策略。
