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. 2009 Apr 1;119(4):717–725. doi: 10.1172/JCI38454

Figure 4. Selective targeting of the depression circuit with DBS in patients with TRD.

Figure 4

(A) Preoperative (pre-op) MRI demonstrating the intended anatomical location for the DBS electrode within the SCC white matter. The four individual contacts on the electrode (numbered 1–4) can be independently stimulated using a programmable implanted pulse generator. (B) Preoperative blood flow PET scan demonstrating baseline hyperactivity of the SCC in the TRD study group (n = 6) relative to healthy controls. (C) The postoperative (post-op) MRI with the electrodes in place within the SCC white matter. (D) Six-month blood flow change relative to preoperative baseline associated with chronic DBS of the optimal SCC contact in four DBS responders. Red indicates increased blood flow and blue indicates decreased blood flow. hth, hypothalamus; MCC, mid-cingulate cortex; sn, substantia nigra; vCd, ventral caudate (adapted with permission from Neuron [ref. 11]).