Join Alik Widge, MD, PhD, associate professor, Department of Psychiatry & Behavioral Sciences, University of Minnesota, for this free Grand Rounds lecture!
Overview
Mental disorders arise from brain circuit dysfunctions, but most of our treatments target the whole brain rather than defined circuits. Deep brain stimulation (DBS) is a more circuit-directed approach that has done well in movement disorders but has very mixed results in randomized clinical trials for mental illness. Part of the difficulty is that psychiatric DBS is delivered in a trial-and-error fashion, without clear evidence that it engages the target circuits. I will discuss new strategies for developing biomarkers to guide that target engagement, centered around the idea of understanding how brain stimulation changes cognition and decision-making. We have identified ways in which DBS can augment top-down executive function and have linked those changes to cortical electrophysiology. In animals, we have developed new approaches to understand how those changes occur and how we can leverage them for clinical benefit. Taken together, these offer the prospect of a new generation of rationally designed brain stimulation therapies.
Learning Objectives
At the conclusion of this activity, attendees will be able to:
- Identify clinical challenges in invasive neurostimulation for mental disorders.
- Describe the role of fronto-striatal circuits in behavioral flexibility.
- Discuss how a domain-focused approach can be more valuable than a diagnosis-focused approach in understanding mechanisms of brain stimulation.
Approval Statements:
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Psychologist Statement: Sheppard Pratt is authorized by the State Board of Examiners of Psychologists as a sponsor of continuing education. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. Sheppard Pratt designates this educational activity for a maximum of 1.0 contact hours for Psychologists.
Social Worker Statement: Sheppard Pratt is authorized by the Board of Social Work Examiners of Maryland to offer continuing education for Social Workers. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. This activity is approved for 1.0 contact hours in Category I credits for Social Workers.
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