Deep brain stimulation (DBS) is a neurosurgical procedure which involves the placement of a medical device called a neurostimulator, which sends electrical impulses, through implanted electrodes, to specific targets in the brain (brain nuclei) for the treatment of movement disorders, including Parkinson's disease, essential tremor, and dystonia. While its underlying principles and mechanisms are not fully understood, DBS directly changes brain activity in a controlled manner.
Deep brain stimulation is a circuit-oriented treatment for mental disorders. Unfortunately, even well-conducted psychiatric DBS clinical trials have yielded inconsistent symptom relief, in part because DBS’ mechanism of action is unclear.
One clue to those mechanisms might lie the efficaciousness of ventral internal capsule/ventral basal ganglion (VCVS) DBS in each major depression (MDD) and neurotic disorder (OCD). MDD and OCD each involve deficits in psychological feature management. Cognitive management depends on anterior cortex (PFC) regions that project into the VCVS. Here, we show that VCVS DBS’ effect is explained in part by the enhancement of PFC-driven cognitive control. DBS improves human subjects’ performance on a psychological feature management task and will increase letter of the alphabet (5–8Hz) oscillations in each medial and lateral perfluorocarbon. The theta increase predicts subjects’ clinical outcomes. Our results counsel a potential mechanistic approach to DBS medical care, supported standardization stimulation to optimize these neurophysiologic phenomena.
