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Abstract #3140

Using Probabilistic Tractography to Assess Optimal Targeting for Subcallosal Cingulate Deep Brain Stimulation: An Informative Case

Ki Sueng Choi1, 2, Paul E. Holtzheimer3, Alexandre R. Franco2, Patricio Riva Posse2, Xiaoping P. Hu1, Helen S. Mayberg2

1Bioengineering(BME), Georgia Institute of Technology / Emory University, Atlanta, GA, United States; 2Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, United States; 3Psychiatry and Surgery, Dartmouth Medical School, Lebanon, NH, United States

Structural connectivity analyses may help improve DBS targeting by highlighting which WM tracts are necessary and sufficient for effective stimulation. We present data on a treatment resistant depression who showed a poor clinical response but who subsequently remitted following a second surgery performed to revise the placement of the DBS within the predefined subcallosal cingulate and differences in the WM projections from the active contacts. These results suggest that precise targeting of specific structural connections between the primary SCC electrode and parts of the medial frontal cortex may be essential for optimal clinical effectiveness of chronic SCC DBS.