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Deep brain stimulation of the internal capsule enhances human cognitive control and prefrontal cortex function

Author

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  • A. S. Widge

    (Massachusetts General Hospital and Harvard Medical School
    Massachusetts Institute of Technology
    University of Minnesota)

  • S. Zorowitz

    (Massachusetts General Hospital and Harvard Medical School
    Princeton Neuroscience Institute)

  • I. Basu

    (Massachusetts General Hospital and Harvard Medical School)

  • A. C. Paulk

    (Massachusetts General Hospital and Harvard Medical School)

  • S. S. Cash

    (Massachusetts General Hospital and Harvard Medical School)

  • E. N. Eskandar

    (Massachusetts General Hospital and Harvard Medical School
    Albert Einstein College of Medicine—Montefiore Medical Center)

  • T. Deckersbach

    (Massachusetts General Hospital and Harvard Medical School)

  • E. K. Miller

    (Massachusetts Institute of Technology)

  • D. D. Dougherty

    (Massachusetts General Hospital and Harvard Medical School)

Abstract

Deep brain stimulation (DBS) is a circuit-oriented treatment for mental disorders. Unfortunately, even well-conducted psychiatric DBS clinical trials have yielded inconsistent symptom relief, in part because DBS’ mechanism(s) of action are unclear. One clue to those mechanisms may lie in the efficacy of ventral internal capsule/ventral striatum (VCVS) DBS in both major depression (MDD) and obsessive-compulsive disorder (OCD). MDD and OCD both involve deficits in cognitive control. Cognitive control depends on prefrontal cortex (PFC) regions that project into the VCVS. Here, we show that VCVS DBS’ effect is explained in part by enhancement of PFC-driven cognitive control. DBS improves human subjects’ performance on a cognitive control task and increases theta (5–8Hz) oscillations in both medial and lateral PFC. The theta increase predicts subjects’ clinical outcomes. Our results suggest a possible mechanistic approach to DBS therapy, based on tuning stimulation to optimize these neurophysiologic phenomena.

Suggested Citation

  • A. S. Widge & S. Zorowitz & I. Basu & A. C. Paulk & S. S. Cash & E. N. Eskandar & T. Deckersbach & E. K. Miller & D. D. Dougherty, 2019. "Deep brain stimulation of the internal capsule enhances human cognitive control and prefrontal cortex function," Nature Communications, Nature, vol. 10(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:10:y:2019:i:1:d:10.1038_s41467-019-09557-4
    DOI: 10.1038/s41467-019-09557-4
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