Clinical Edge

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Frontal White Matter Predicts Efficacy of DBS in Major Depression

In 2 trials of deep brain stimulation (DBS) to the superolateral medial forebrain bundle, biomarkers that may allow identification of future responders to DBS therapy in major depression (MD) showed potential as a step toward personalized treatments for psychiatric disorders. Data from 24 patients were analyzed. The goal was to identify informed features that allow to predict treatment response. Researchers found:

  • A left fronto-polar and party orbitofrontal region was identified that showed increased volume in preoperative anatomical scans.
  • Statistical analysis showed that the volume of this “HUB-region” is predictive for later MADRS response from DBS.
  • The HUB region connects to typical fiber pathways that have been addressed before in therapeutic DBS in MD.
  • Left frontal volume growth may indicate intrinsic activity upon disconnection from the main emotional network.


Coenen VA, et al. Frontal white matter architecture predicts efficacy of deep brain stimulation in major depression. [Published online ahead of print August 21, 2019]. Transl Psychiatry. doi: 10.1038/s41398-019-0540-4.