Role of functional imaging in the development and refinement of invasive neuromodulation for psychiatric disorders

Table 3 Treatment-resistant depression deep brain stimulation targets: Activation/deactivation of cortical and subcortical targets

	NAc_DBS	SCG_DBS	DLFPC_ EpCS
Frontal cortex
Ventral superior frontal sulcus	↓Bewernick1c
Dorsal superior frontal sulcus	↓Bewernick1c
Medial frontal gyrus	↑Schlaepfer; ↓Bewernick1c
Superior frontal gyrus	↑Schlaepfer		↓Kopell2
Inferior frontal gyrus	↓Schlaepfer1a
Prefrontal cortex (PFC)	↑Knight1d,11
Dorsomedial PFC	↑Schlaepfer1a	↓Lozano4
Dorsolateral PFC	↑Schlaepfer1a	↑Mayberg8; ↓ Lozano4,6f	↑Kopell1f;↓Kopell2
Ventral prefrontal
Ventrolateral prefrontal	↓Schlaepfer1a; ↑Knight	↑Lozano6f
Ventromedial prefrontal	↓Schlaepfer1a	↑Lozano4
Medial prefrontal		↓Mayberg8
Dorsal frontal pole		↓Lozano4
Ventral frontal pole		↓Lozano4
Cingulate	↑Schlaepfer1a; ↑Knight1d,11
Posterior cingulate	↓Bewernick1c	↑Mayberg7b; ↑Lozano5	↓Kopell2
Subgenual cingulate	↓Bewernick1c,2	↓Mayberg7b; ↑Lozano4
Anterior cingulate	↓Schlaepfer1a; ↑Knight1d	↑Mayberg8; ↓Lozano6f
Orbitofrontal cortex	↓Bewernick1e	↓Mayberg9b	↑Kopell1f
Lateral orbitofrontal		↑Lozano4
Medial orbitofrontal		↓Lozano6f
Premotor cortex		↑Mayberg7b; ↑Lozano3
Dorsolateral premotor		↓Lozano3
Striatum
Ventral striatum	↑Schlaepfer1a; ↑Knight
Caudate	↓Bewernick1c; ↑Schlaepfer1c	↑(rostral) ↓(caudal)Lozano4
Putamen	↑Schlaepfer
Insula	↓Schlaepfer1a; ↑Knight1d	↓Mayberg7b; ↑Lozano4
Amygdala	↑Schlaepfer1a; ↑Bewernick1c,2
Pons		↓Lozano5
Thalamus	↓Bewernick1c; ↓Schlaepfer1a↓Knight1d,10
Hypothalamus		↓Mayberg7b
Hippocampus/parahippocampus	↑Schlaepfer; ↑Knight1d	↑Lozano45

¹Statistically significant,

^bP < 0.001,

^dP < 0.0001,

^aP < 0.05,

^fP < 0.005,

^cP = 0.05,

^eP = 0.038 vs scans;

²Statistically correlated with change in depression scale;

³de/activation at 3 mo only;

⁴de/activation at 3 and 6 mo;

⁵de/activation at 6 mo only;

⁶significant between scans at 6 mo only;

⁷significant between scans at 3 and 6 mo;

⁸statistically correlated at 3 and 6 mo;

⁹significant between scans at 3 mo only; ¹⁰as the stimulation voltage increased from 3 V to 5 V, the region of BOLD signal modulation increased; ¹¹as the stimulation voltage increased from 3 V to 5V, the region of BOLD signal modulation area decreased for n = 2 pigs; NAc: Nucleus accumbens; DBS: Deep brain stimulation; SCG: Subcallosal cingulate gyrus; DLFPC: Dorsolateral prefrontal cortex; EpCS: Epidural cortical stimulation; BOLD: Blood oxygen level dependent.