Decoding depression during subcallosal cingulate deep brain stimulation

Deep brain stimulation of subcallosal cingulate white matter (SCCwm-DBS) alleviates symptoms of treatment resistant depression (TRD) over months of therapy. Readouts of depression symptom severity derived from neural recordings are needed for more systematic study and improvement of the therapy. In this study, we measured local field potentials (LFP) multiple times a day alongside seven months of therapy using the Activa PC+S™ in six patients treated with SCCwm-DBS. We found significant changes in oscillatory power between early and late therapy after accounting for stimulation-related distortions, particularly within the β band. We then used a decoder strategy to identify oscillatory activity that tracked with depression measurements over seven months, with asymmetric δ and β oscillations contributing to a statistically significant prediction of 10% of the measured depression signal. Simulating its use in clinical decision-making, we demonstrated that the DR-SCC yield clinically meaningful information that can augment other measures of depression state. Ultimately, this DR-SCC provides a data-driven first-step towards objectively tracking chronic recovery after antidepressant DBS implantation and developing adaptive DBS strategies in the presence of active stimulation. ### Competing Interest Statement CCM is a paid consultant for Boston Scientific Neuromodulation, receives royalties from Hologram Consultants, Neuros Medical, Qr8 Health, and is a shareholder in the following companies: Hologram Consultants, Surgical Information Sciences, CereGate, Autonomic Technologies, Cardionomic, Enspire DBS. HM has a consulting agreement with Abbott Labs (previously St Jude Medical, Neuromodulation), which has licensed her intellectual property to develop SCC DBS for the treatment of severe depression (US 2005/0033379A1). RG serves as a consultant to and receives research support from Medtronic, and serves as a consultant to Abbott Labs. The terms of these arrangements have been approved by Emory University, Icahn School of Medicine, and Case Western Reserve in accordance with policies to manage conflict of interest. All other authors have no COI to declare.