Treatment, Neuromodulation

Helen S. Mayberg¹

Critical to the refinement of subcallosal cingulate DBS as a therapeutic strategy for patients with intractable depression will be the full characterization of brain systems mediating abnormal mood states as well as those mediating successful and unsuccessful response. Functional neuroimaging first provided the critical foundation for target selection in initial pilot studies. Imaging has further played an important role in quantifying physiological effects of chronic stimulation, with emerging evidence of differential patterns in responders and non-responders. As clinical studies proceed, development of reliable biomarkers to improve patient recruitment, enhance surgical targeting and optimize parameter selection will be a necessary next step.