Therapeutic deep brain stimulation targeting BNST-NAc circuit driven large-scale brain networks in treatment-resistant depression

source extracted confidence: high 2026-04-09
#humans #deep-brain-stimulation #depressive-disorder-treatment-resistant #nucleus-accumbens #male

Therapeutic deep brain stimulation targeting BNST-NAc circuit driven large-scale brain networks in treatment-resistant depression

Ye et al., 2025 | Transl Psychiatry | Rct

Citation

Ye Kuanghao, Cao Yu, ... Lv Xin. Therapeutic deep brain stimulation targeting BNST-NAc circuit driven large-scale brain networks in treatment-resistant depression. Transl Psychiatry. 2025-Oct-31;15(1):442. doi:10.1038/s41398-025-03669-w

Abstract

Therapeutic deep brain stimulation (DBS) targeting the striatum shows promise for treatment-resistant depression (TRD), but its effects on large-scale brain network dynamics remain unclear. This study aimed to elucidate how DBS targeting the bed nucleus of the stria terminalis-nucleus accumbens (BNST-NAc) circuit modulates network dynamics, assessed via electroencephalography (EEG) microstates, and how these changes relate to local circuit activity. In a randomized, double-blind, crossover trial with 10 TRD patients, synchronous resting-state scalp EEG and NAc local field potential (LFP) data were collected during active and sham stimulation. Microstate analysis identified five consistent microstates (A-E). Compared to sham, therapeutic DBS increased the coverage and occurrence of microstates A and B. Transition probabilities involving A ⇌ C, E → B, and B → A were increased during active stimulation, whereas C ⇌ D transitions were reduced. Several of these changes, notably the reduced transitions between C and D, were associated with symptom improvements. Critically, time-locked analysis revealed that a significant increase in NAc gamma-band aperiodic activity specifically preceded transitions from microstate C to D, but not from D to C. These findings provide multi-scale mechanistic evidence that BNST-NAc DBS drives clinically relevant EEG microstate alterations in TRD patients, which are driven by specific gamma aperiodic activity patterns in the NAc. Combined EEG-LFP microstate signatures may therefore serve as valuable biomarkers for DBS treatment response.

Key Findings

Combined EEG-LFP microstate signatures may therefore serve as valuable biomarkers for DBS treatment response.

Outcomes Measured

  • depression

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition depression

MeSH Terms

  • Humans
  • Deep Brain Stimulation
  • Depressive Disorder, Treatment-Resistant
  • Nucleus Accumbens
  • Male
  • Double-Blind Method
  • Female
  • Septal Nuclei
  • Middle Aged
  • Electroencephalography
  • Cross-Over Studies
  • Adult
  • Nerve Net

Evidence Classification

  • Level: Rct
  • Publication Types: Journal Article, Randomized Controlled Trial
  • Vertical: NAC-mental

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09