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13 Circuit-based neuromodulation across symptoms and disorders
  1. Shan Siddiqi

Abstract

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):

  1. 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.

  2. 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).

  3. 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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