Advanced brain stimulation approaches for treating depression and anxiety

Hosting institution

The Centre for Systems Modelling and Quantitative Biomedicine, University of Birmingham

Description

Depression and anxiety are among the most common mental health problems worldwide. The existing drug-based therapies often have negative side effects and are ineffective in around 30% of cases. Non-invasive brain stimulation is a promising alternative to pharmacological treatment. For this webinar, we have invited four outstanding researchers with diverse but complementary expertise in the field of brain stimulation who will be presenting their latest work. We believe that this webinar will help us better understand new and emerging approaches for treating depression and anxiety.

Programme

• Opening remarks, 9:15 – 9:30
• Dr Luca Cocchi, 9:30 – 10:00, “Precision brain network therapeutics”
• Professor Richard Morriss, 10:00 – 10:30, “Cranial electrostimulation as a home-based microcurrent treatment”
• Professor Jonathan Roiser, 10:30 – 11:00, “Using cognitive neuroscience to improve mental health interventions”
• Professor Marcus Kaiser, 11:00 – 11:30, “Using connectome-based computational models to inform brain stimulation interventions”
• Closing remarks, 11:30 – 11:45

Speakers | bio and abstracts

Luca Cocchi

Luca obtained his PhD in Neuroscience at the University of Lausanne and Geneva (Switzerland) in 2007. Following postdoctoral training in leading research institutes, including the Melbourne Neuropsychiatry Centre (University of Melbourne) and the Queensland Brain Institute (University of Queensland), Luca joined QIMR Berghofer in 2016 and started the Clinical Brain Networks group in 2018. Luca's research focuses on understanding how functionally specialised regions of the brain communicate, how that communication breaks down in mental illness, and how brain stimulation therapy to restore that communication can be made more predictable, efficient and effective. Advances from this research program have resulted in the establishment of a not-for-profit clinical centre offering neuroimaging-guided and robotically-delivered brain stimulation (Queensland Neurostimulation Centre).

Talk: Precision brain network therapeutics 

Advances in psychiatry have been slow, with few new effective treatments developed for decades. Thus, there is  a pressing need to understand the brain basis of mental illness and develop safe and effective treatments. I will start by presenting how human brain connectomics has advanced our knowledge on brain functions in health and disease. In the second half of the talk, I will showcase how knowledge acquired via this research can inform the development of new therapies for symptoms of mental illness. I will exemplify these translational opportunities by highlighting a new robotically-delivered connectomics-guided transcranial magnetic stimulation therapy for refractory depression.

Richard Morriss

Richard is Professor of Psychiatry at the University of Nottingham and Honorary Consultant Psychiatrist at Nottinghamshire Healthcare NHS Trust. His research interests include depression, anxiety and bipolar disorder in all settings, digital and neuromodulation technology. He is a consultant general adult psychiatrist in a city-based community mental health team and also runs a specialist clinical pathway for treatment resistant bipolar disorder and depression for the county of Nottinghamshire. He is a NIHR Senior Investigator, and mental health lead or deputy lead for 3 national NIHR mental health centres: ARC East Midlands, a centre for applied research and its implementation into NHS practice; NIHR MindTech Health Technology Co-operative, a national centre for digital mental health; and the Mental Health and Technology theme in the Nottingham NIHR Biomedical Research Centre. 

Talk: Cranial electrostimulation as a home-based microcurrent treatment

 I will discuss recent research in Nottingham and internationally on cranial electrostimulation (CES), a home based microcurrent treatment CE marked and FDA supported for the management of generalised anxiety disorder and depression. The talk will discuss what CES is, why it is popular with some people with anxiety and depression, evidence of clinical and cost effectiveness, tolerability and safety, and mechanism of action. The limitations of this evidence will be highlighted.

Jonathan Roiser 

Jonathan is Professor of Neuroscience and Mental Health and Deputy Director at the UCL Institute of Cognitive Neuroscience. His research interests lie in understanding the brain and psychological processes driving mental health problems, especially disrupted motivation in depression. He has published over 150 peer-reviewed papers and his recent research has been funded by Wellcome, the MRC, the Leverhulme Trust and the Rosetrees Trust. He founded and directs two PhD schemes: the UCL-NIMH Joint Doctoral Training Program in Neuroscience; and the UCL Wellcome 4-year PhD Programme in Mental Health Science.

Talk: Using cognitive neuroscience to improve mental health interventions 

There is considerable need to develop tailored approaches to mental health treatment. Cognitive neuroscience offers a number of techniques with potential for clinical application, but in many cases there is insufficient understanding of their underlying mechanisms. In the case of non-invasive brain stimulation, there is limited knowledge of the underlying cognitive mechanisms targeted by protocols that are known to have an antidepressant effect (Nord et al. 2017, Social Cognitive and Affective Neuroscience; Nord & Roiser 2015, Advances in Clinical Neuroscience and Rehabilitation). We conducted the first randomised controlled trial testing a type of brain stimulation, transcranial direct current stimulation (tDCS), as an augmentative treatment to psychotherapy in patients with depression (Nord et al. 2019, Neuropsychopharmacology). This trial tested a novel treatment for depression (tDCS) while concurrently measuring potential cognitive and neural predictors of treatment response. We found that depressed patients have a moderately-sized but variable response to tDCS, and that activation in the left dorsolateral prefrontal cortex (measured using functional magnetic resonance imaging during working memory performance) specifically predicted clinical response to tDCS. This finding reinforces the utility of cognitive neuroscience in a clinical context, showing the potential to reveal and refine treatment targets to improve mental health interventions.

Marcus Kaiser

Marcus is leader of Neuroinformatics UK representing more than 600 researchers in the field (http://www.neuroinformatics.org.uk/) and Chair of the Neuroinformatics Special Interest Group of the British Neuroscience Association. After studying biology and computer science, he obtained his PhD, funded by a fellowship from the German National Academic Foundation, from Jacobs University Bremen in 2005. In 2016, he was elected Fellow of the Royal Society of Biology. He is on the editorial boards of Network Neuroscience (MIT Press), PLOS Computational Biology, and Royal Society Open Science, and author of the first review on connectomics. Research interests are understanding the origin of brain disorders through modelling brain development and using models to inform therapeutic interventions, in particular using non-invasive brain stimulation (see http://www.dynamic-connectome.org/).

Talk: Using connectome-based computational models to inform brain stimulation interventions

The complete set of connections in the brain is called our connectome. Over the last 20 years we have found out more about how this network is organised and how this organisation is linked to brain function. For example, highly-connected brain regions (hubs) play critical roles in information processing and are involved in many brain diseases. I will outline how networks change for a range of brain disorders, from networks that produce seizures for epilepsy to networks that produce hallucinations in certain types of dementia. Given these changes, can we alter the structure of these networks and thereby improve cognition in patients?

Brain stimulation is an option to achieve this and has been proposed as an alternative treatment to pharmaceutical drugs with a potential to reduce side effects and improve cognitive function. I will outline how computational models based on brain connectivity information can help to identify network targets and to find personalised stimulation protocols. In particular, I will highlight how focused ultrasound, a novel non-invasive technology for brain stimulation, can directly target deep-brain structures involved in emotion and memory processing opening up a way to new interventions. More information can also be found in my book ‘Changing Connectomes’ (MIT Press, 2020)