Two Baylor College of Medicine physicians have been awarded an $8.5 million grant to work toward a better understanding of the neurocircuitry of depression. The grant is from the National Institute of Neurological Disorders and Stroke, a part of the National Institutes of Health BRAIN Initiative.
Dr. Sameer Sheth, associate professor of neurosurgery at Baylor, and Dr. Wayne Goodman, professor and chair of the Menninger Department of Psychiatry and Behavioral Sciences at Baylor, are co-principal investigators on the research that will investigate brain networks that could be responsible for treatment-resistant depression (TRD), and how the use of deep brain stimulation can be used to treat the disorder. Deep brain stimulation is the implantation of a neurostimulator that sends electrical impulses through implanted electrodes to specific areas of the brain. A second research site is led by Dr. Nader Pouratian, associate professor of neurosurgery at UCLA.
“There is a large unmet need for developing new approaches to treatment-resistant depression, which has become a public health issue. Deep brain stimulation has been studied as a treatment for the condition, but findings have been inconsistent,” Goodman said. “Studying the neurocircuitry of the brain affecting depression will allow us to identify a more precise area to target through deep brain stimulation. We will be able to have more accurate results of what works and what doesn’t work when we can better pinpoint those areas in the brain.”
Sheth, who also is a neurosurgeon at Baylor St. Luke’s Medical Center, explains that this current study will use a novel DBS system that is able to perform directional steering, technology that is not found in past models of DBS systems. This will allow their team to target distinct areas of the brain that have been implicated in bi-directional modulation of depression neurocircuits.
“The proposed studies will investigate the feasibility and safety of using a next-generation DBS system, the Boston Scientific Vercise DBS system, to ‘steer’ stimulation simultaneously to two different brain regions implicated in treatment-resistant depression that may lead to new and better treatments for this and other severe neuropsychiatric disorders,” Sheth said.
Those two different brain regions to be targeted are the subgenual cingulate and ventral capsule/ventral striatum. These areas are hubs in distinct yet partially overlapping networks in the brain that have been implicated in TRD.
The goals of the study include physiological validation of the novel DBS technology to target specific networks, looking at behavioral changes with the targeted stimulation and also focusing on safety, feasibility and efficacy in study volunteers.
The BRAIN Initiative was created in 2013 with the goal of creating deeper understanding of devastating brain disorders and diseases while also developing new technology, treatment and cures through innovative research. Four federal agencies, the National Institutes of Health, the National Science Foundation, the Food and Drug Administration and the Defense Advanced Research Projects Agency, committed more $110 million to the initiative.