Evidence map›Paper›PMID 32580207›Full record

Trial reportNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2020

Metabolic activity in subcallosal cingulate predicts response to deep brain stimulation for depression.

Elliot C Brown, Darren L Clark, Nils D Forkert, Christine P Molnar, Zelma H T Kiss, Rajamannar Ramasubbu

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.

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  17. Serotonin 5-HTPsychopharmacology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Elliot C BrownMathison Centre for Mental Health Research & Education, University of Calgary, Calgary, AB, Canada.
Darren L ClarkMathison Centre for Mental Health Research & Education, University of Calgary, Calgary, AB, Canada.
Nils D ForkertHotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.ORCID http://orcid.org/0000-0003-2556-3224
Christine P MolnarDepartment of Radiology, University of Calgary, Calgary, AB, Canada.
Zelma H T KissMathison Centre for Mental Health Research & Education, University of Calgary, Calgary, AB, Canada.
Rajamannar RamasubbuMathison Centre for Mental Health Research & Education, University of Calgary, Calgary, AB, Canada. rramasub@ucalgary.ca.ORCID http://orcid.org/0000-0002-7463-5047
University of Calgary · CAAlberta Health Services · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Subcallosal cingulate (SCC) deep brain stimulation (DBS) is a promising therapy for treatment-resistant depression (TRD), but response rates in open-label studies were not replicated in a large multicenter trial. Identifying biomarkers of response could improve patient selection and outcomes. We examined SCC metabolic activity as both a predictor and marker of SCC DBS treatment response. Brain glucose metabolism (CMRGlu) was measured with [18F] FDG-PET at baseline and 6 months post DBS in 20 TRD patients in a double-blind randomized controlled trial where two stimulation types (long pulse width (LPW) n = 9 and short pulse width (SPW) n = 11) were used. Responders (n = 10) were defined by a ≥48% reduction in Hamilton Depression Rating Scale scores after 6 months. The response rates were similar with five responders in each stimulation group: LPW (55.6%) and SPW (44.5%). First, differences in SCC CMRGlu in responders and non-responders were compared at baseline. Then machine learning analysis was performed with a leave-one-out cross-validation using a Gaussian naive Bayes classifier to test whether baseline CMRGlu in SCC could categorize responders. Finally, we compared 6-month change in metabolic activity with change in depression severity. All analyses were controlled for age. Baseline SCC CMRGlu was significantly higher in responders than non-responders. The machine learning analysis predicted response with 80% accuracy. Furthermore, reduction in SCC CMRGlu 6 months post DBS correlated with symptom improvement (r(17) = 0.509; p = 0.031). This is the first evidence of an image-based treatment selection biomarker that predicts SCC DBS response. Future studies could utilize SCC metabolic activity for prospective patient selection.

Indexed as

Deep Brain StimulationDepressive Disorder, Treatment-ResistantBayes TheoremDepressionGyrus CinguliHumansProspective StudiesTreatment Outcome

Identifiers

PMID32580207
PMCPMC7419290
OpenAlexW3037705498

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.