Grant: Project Grant

A large proportion of patients with post-traumatic stress disorder (PTSD) remains symptomatic despite optimized medical treatment. Deep brain stimulation (DBS) involves the delivery of a low electrical current though wires (electrodes) implanted in the brain. Because DBS is a surgical procedure, personalizing this treatment according to the patients' symptoms and knowing beforehand who will benefit from surgery are of extreme importance. As conducted today, DBS is delivered to patients continuously (the system is never turned off). It would be ideal if we could understand how the brain responds to PTSD symptoms, so that stimulation might be delivered only when necessary. In this proposal patients will be implanted with a new DBS system capable of recording brain activity. In a first set of experiments, we will establish the safety and efficacy of using DBS to treat PTSD and study ways of predicting who will respond to the procedure. In a second set of studies, we will collect information from several exams (e.g., magnetic resonance imaging, positron emission tomography) to understand how the brain responds to DBS. We expect that following stimulation there might be an improved response to psychotherapy, so that patients who were unresponsive before the operation may get better with this treatment modality in the postoperative period. Finally, in a final set of experiments we will use brand new technology to record brain activity when patients present PTSD symptoms to characterize optimal ways to deliver individualized stimulation to each particular patient.