Shan Siddiqi is an instructor of psychiatry at Harvard Medical School and Director of Psychiatric Neuromodulation Research at the new Center for Brain Circuit Therapeutics at Brigham & Women’s Hospital. He completed his general psychiatry residency at Washington University in St. Louis, a neuropsychiatry fellowship at McLean/Massachusetts General Hospital, and a research fellowship at the Berenson-Allen Center for Noninvasive Brain Stimulation. His research is focused on personalizing TMS targets using brain circuit mapping and clinical phenomenology.
Abstract This session will cover three approaches to circuit-based targeting of brain stimulation treatments such as transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS):
Symptom-specific: In two datasets of TMS for depression (n=111), dysphoric symptoms (e.g. sadness) responded best to stimulation of one circuit, while anxious/somatic symptoms responded to a different circuit.
Cross-modality: Across 14 datasets, similar ‘depression circuits’ were connected to TMS sites that relieve depression (n=151), DBS sites that modulate depression (n=101), and lesions that cause depression (n=461).
Diagnosis-specific: Lesions protective against PTSD (n=189) were connected to a common circuit (split-half cross-validation p<0.05). Lesions protective against nicotine use disorder (n=103) and those that reduce alcoholism risk (n=186) were also connected to a common circuit (p<0.05).
This illustrates a framework for circuit-targeted neuromodulation studies – neuromodulation can target different circuits for different symptoms; a common circuit can be modulated by TMS, DBS, and lesions; and lesions can reveal targets for other disorders.
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