The Impact of Mirth-Inducing Ventral Striatal Deep Brain Stimulation on Functional and Effective Connectivity

William S. Gibson, Shinho Cho, Osama A. Abulseoud, Krzysztof R. Gorny, Joel P. Felmlee, Kirk M. Welker, Bryan T. Klassen, Hoon Ki Min, Kendall H. Lee

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is an investigational therapy for treatment-resistant obsessive-compulsive disorder. The ability of VC/VS DBS to evoke spontaneous mirth in patients, often accompanied by smiling and laughter, is clinically well documented. However, the neural correlates of DBS-evoked mirth remain poorly characterized. Patients undergoing VC/VS DBS surgery underwent intraoperative evaluation in which mirth-inducing and non-mirth-inducing stimulation localizations were identified. Using dynamic causal modeling (DCM) for fMRI, the effect of mirth-inducing DBS on functional and effective connectivity among established nodes in limbic cortico-striato-thalamo-cortical (CSTC) circuitry was investigated. Both mirth-inducing and non-mirth-inducing VC/VS DBS consistently resulted (conjunction, global null, family-wise error-corrected P < 0.05) in activation of amygdala, ventral striatum, and mediodorsal thalamus. However, only mirth-inducing DBS resulted in functional inhibition of anterior cingulate cortex. Dynamic causal modeling revealed that mirth-inducing DBS enhanced effective connectivity from anterior cingulate to ventral striatum, while attenuating connectivity from thalamus to ventral striatum relative to non-mirth-inducing stimulation. These results suggest that DBS-evoked mood elevation is accompanied by distinct patterns of limbic thalamocortical connectivity. Using the novel combination of DBS-evoked mood alteration and functional MRI in human subjects, we provide new insights into the network-level mechanisms that influence affect.

Original languageEnglish (US)
Pages (from-to)2183-2194
Number of pages12
JournalCerebral cortex (New York, N.Y. : 1991)
Volume27
Issue number3
DOIs
StatePublished - Mar 1 2017

Keywords

  • DBS
  • fMRI
  • mood
  • nucleus accumbens
  • obsessive compulsive disorder

Fingerprint Dive into the research topics of 'The Impact of Mirth-Inducing Ventral Striatal Deep Brain Stimulation on Functional and Effective Connectivity'. Together they form a unique fingerprint.

Cite this