Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Nat Hum Behav. 2021 Dec;5(12):1707-1716. doi: 10.1038/s41562-021-01161-1. Epub 2021 Jul 8.
Damage to specific brain circuits can cause specific neuropsychiatric symptoms. Therapeutic stimulation to these same circuits may modulate these symptoms. To determine whether these circuits converge, we studied depression severity after brain lesions (n = 461, five datasets), transcranial magnetic stimulation (n = 151, four datasets) and deep brain stimulation (n = 101, five datasets). Lesions and stimulation sites most associated with depression severity were connected to a similar brain circuit across all 14 datasets (P < 0.001). Circuits derived from lesions, deep brain stimulation and transcranial magnetic stimulation were similar (P < 0.0005), as were circuits derived from patients with major depression versus other diagnoses (P < 0.001). Connectivity to this circuit predicted out-of-sample antidepressant efficacy of transcranial magnetic stimulation and deep brain stimulation sites (P < 0.0001). In an independent analysis, 29 lesions and 95 stimulation sites converged on a distinct circuit for motor symptoms of Parkinson's disease (P < 0.05). We conclude that lesions, transcranial magnetic stimulation and DBS converge on common brain circuitry that may represent improved neurostimulation targets for depression and other disorders.
特定脑回路的损伤会导致特定的神经精神症状。对这些相同回路进行治疗性刺激可能会调节这些症状。为了确定这些回路是否收敛，我们研究了脑损伤后的抑郁严重程度（n=461，5 个数据集）、经颅磁刺激（n=151，4 个数据集）和深部脑刺激（n=101，5 个数据集）。与抑郁严重程度最相关的损伤和刺激部位在所有 14 个数据集中都与相似的脑回路相连（P<0.001）。损伤、深部脑刺激和经颅磁刺激产生的回路相似（P<0.0005），重度抑郁症患者与其他诊断患者产生的回路也相似（P<0.001）。与该回路的连通性预测了经颅磁刺激和深部脑刺激部位的抗抑郁治疗效果（P<0.0001）。在一项独立分析中，29 个损伤和 95 个刺激部位汇聚到一个与帕金森病运动症状相关的特定回路（P<0.05）。我们得出结论，损伤、经颅磁刺激和 DBS 都集中在共同的脑回路中，这可能代表了改善抑郁和其他疾病的神经刺激靶点。
