Closed-loop neuromodulation in an individual with treatment-resistant depression

Nat Med. 2021 Oct;27(10):1696-1700. doi: 10.1038/s41591-021-01480-w. Epub 2021 Oct 4.

Abstract

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.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain / radiation effects*
  • Deep Brain Stimulation / methods*
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / diagnostic imaging
  • Depressive Disorder, Major / pathology
  • Depressive Disorder, Major / therapy*
  • Electric Stimulation / methods*
  • Female
  • Humans
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Biomarkers