Weill Institute for Neurosciences, University of California, San Francsico, CA, USA.
Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
Nat Med. 2021 Oct;27(10):1696-1700. doi: 10.1038/s41591-021-01480-w. Epub 2021 Oct 4.
Deep brain stimulation is a promising treatment for neuropsychiatric conditions such as major depression. It could be optimized by identifying neural biomarkers that trigger therapy selectively when symptom severity is elevated. We developed an approach that first used multi-day intracranial electrophysiology and focal electrical stimulation to identify a personalized symptom-specific biomarker and a treatment location where stimulation improved symptoms. We then implanted a chronic deep brain sensing and stimulation device and implemented a biomarker-driven closed-loop therapy in an individual with depression. Closed-loop therapy resulted in a rapid and sustained improvement in depression. Future work is required to determine if the results and approach of this n-of-1 study generalize to a broader population.
脑深部电刺激是一种有前途的神经精神疾病治疗方法，例如重度抑郁症。通过识别在症状严重度升高时选择性触发治疗的神经生物标志物，可对其进行优化。我们开发了一种方法，首先使用多日颅内电生理学和局部电刺激来识别个性化的症状特异性生物标志物和治疗位置，在此位置刺激可改善症状。然后，我们植入了慢性深部脑感知和刺激设备，并在一名抑郁症患者中实施了基于生物标志物的闭环治疗。闭环治疗导致抑郁迅速而持续改善。需要进一步的工作来确定这项单病例研究的结果和方法是否可推广到更广泛的人群。
