Universität zu Köln

Baldermann, Juan Carlos, Melzer, Corina, Zapf, Alexandra, Kohl, Sina, Timmermann, Lars, Tittgemeyer, Marc ORCID: 0000-0001-5072-2149, Huys, Daniel, Visser-Vandewalle, Veerle, Kuhn, Andrea A., Horn, Andreas ORCID: 0000-0002-0695-6025 and Kuhn, Jens (2019). Connectivity Profile Predictive of Effective Deep Brain Stimulation in Obsessive-Compulsive Disorder. Biol. Psychiatry, 85 (9). S. 735 - 744. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1873-2402

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Abstract

BACKGROUND: Deep brain stimulation for obsessive-compulsive disorder is a rapidly developing treatment strategy for treatment-refractory patients. Both the exact target and impact on distributed brain networks remain a matter of debate. Here, we investigated which regions connected to stimulation sites contribute to clinical improvement effects and whether connectivity is able to predict outcomes. METHODS: We analyzed 22 patients (13 female) with treatment-refractory obsessive-compulsive disorder undergoing deep brain stimulation targeting the anterior limb of the internal capsule/nucleus accumbens. We calculated stimulation-dependent optimal connectivity separately for patient-specific connectivity data of 10 patients and for 12 additional patients using normative connectivity. Models of optimal connectivity were subsequently used to predict outcome in both an out-of-sample cross-validation and a leave-one-out cross-validation across the whole group. RESULTS: The resulting models successfully cross-predicted clinical outcomes of the respective other sample, and a leave-one-out cross-validation across the whole group further demonstrated robustness of our findings (r = .630, p < .001). Specifically, the degree of connectivity between stimulation sites and medial and lateral prefrontal cortices significantly predicted clinical improvement. Finally, we delineated a frontothalamic pathway that is crucial to be modulated for beneficial outcome. CONCLUSIONS: Specific connectivity profiles, encompassing frontothalannic streamlines, can predict clinical outcome of deep brain stimulation for obsessive-compulsive disorder. After further validation, our findings may be used to guide both deep brain stimulation targeting and programming and to inform noninvasive neuromodulation targets for obsessive-compulsive disorder.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Baldermann, Juan Carlos UNSPECIFIED UNSPECIFIED UNSPECIFIED Melzer, Corina UNSPECIFIED UNSPECIFIED UNSPECIFIED Zapf, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Kohl, Sina UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Tittgemeyer, Marc UNSPECIFIED orcid.org/0000-0001-5072-2149 UNSPECIFIED Huys, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Andrea A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, Andreas UNSPECIFIED orcid.org/0000-0002-0695-6025 UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-150140
DOI:	10.1016/j.biopsych.2018.12.019
Journal or Publication Title:	Biol. Psychiatry
Volume:	85
Number:	9
Page Range:	S. 735 - 744
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1873-2402
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BED NUCLEUS; MRI; PARCELLATION Multiple languages Neurosciences; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15014