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Review
. 2021;8(1):11-19.
doi: 10.1007/s40473-021-00226-9. Epub 2021 Feb 15.

Predicting Response to Brain Stimulation in Depression: a Roadmap for Biomarker Discovery

Camilla L Nord  1
Affiliations
Review

Predicting Response to Brain Stimulation in Depression: a Roadmap for Biomarker Discovery

Camilla L Nord. Curr Behav Neurosci Rep. 2021.

Abstract

Purpose of review: Clinical response to brain stimulation treatments for depression is highly variable. A major challenge for the field is predicting an individual patient's likelihood of response. This review synthesises recent developments in neural predictors of response to targeted brain stimulation in depression. It then proposes a framework to evaluate the clinical potential of putative 'biomarkers'.

Recent findings: Largely, developments in identifying putative predictors emerge from two approaches: data-driven, including machine learning algorithms applied to resting state or structural neuroimaging data, and theory-driven, including task-based neuroimaging. Theory-driven approaches can also yield mechanistic insight into the cognitive processes altered by the intervention.

Summary: A pragmatic framework for discovery and testing of biomarkers of brain stimulation response in depression is proposed, involving (1) identification of a cognitive-neural phenotype; (2) confirming its validity as putative biomarker, including out-of-sample replicability and within-subject reliability; (3) establishing the association between this phenotype and treatment response and/or its modifiability with particular brain stimulation interventions via an early-phase randomised controlled trial RCT; and (4) multi-site RCTs of one or more treatment types measuring the generalisability of the biomarker and confirming the superiority of biomarker-selected patients over randomly allocated groups.

Keywords: Biomarkers; Brain stimulation; Depression; Predicting response; TMS; tDCS.

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A pragmatic framework for identifying and testing brain stimulation biomarkers
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References

    1. •• Mutz J, Vipulananthan V, Carter B, Hurlemann R, Fu CH, Young AH. Comparative efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults: systematic review and network meta-analysis. bmj. 2019;364. Recent systematic review and meta-analysis comparing efficacy of different brain stimulation interventions for depression - PMC - PubMed
    1. Dandekar M, Fenoy A, Carvalho A, Soares J, Quevedo J. Deep brain stimulation for treatment-resistant depression: an integrative review of preclinical and clinical findings and translational implications. Mol Psychiatry. 2018;23(5):1094–1112. - PubMed
    1. Pascual-Leone A, Valls-Sole J, Wasserman E, Hallet M. Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex. Brain. 1994;117(4):847–858. - PubMed
    1. Mayberg HS, Lozano AM, Voon V, McNeely HE, Seminowicz D, Hamani C, et al. Deep brain stimulation for treatment-resistant depression. Neuron. 2005;45(5):651–660. - PubMed
    1. Fregni F, Boggio PS, Nitsche MA, Marcolin MA, Rigonatti SP, Pascual-Leone A. Treatment of major depression with transcranial direct current stimulation. Bipolar Disord. 2006;8(2):203–204. - PubMed

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