The Neural Crossroads of Psychiatric Illness: An Emerging Target for Brain Stimulation

TITLE:
The Neural Crossroads of Psychiatric Illness: An Emerging Target for Brain Stimulation.

AUTHORS:
Downar J; Blumberger DM; Daskalakis ZJ. Institution Downar, Jonathan. Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada; MRI-Guided rTMS Clinic, University Health Network, Toronto, ON, Canada.

ELECTRONIC ADDRESS:
jonathan.downar@uhn.ca. Blumberger, Daniel M. Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention and Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. Daskalakis, Zafiris J. Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention and Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.

SOURCE:
Trends in Cognitive Sciences. 20(2):107-20, 2016 Feb.

ABSTRACT:
Recent meta-analyses of structural and functional neuroimaging studies are converging on a collective core of brain regions affected across most psychiatric disorders, centered on the dorsal anterior cingulate cortex (dACC) and anterior insula. These nodes correspond well to an anterior cingulo-insular (aCIN) or ‘salience’ network, and stand at a crossroads within the functional architecture of the brain, acting as a switch to deploy other major functional networks according to motivational demands and environmental constraints. Therefore, disruption of these ‘linchpin’ areas may be disproportionately disabling, even when other networks remain intact. These regions may represent promising targets for a new generation of anatomically directed brain stimulation treatments. Here, we review the potential of the psychiatric core areas as targets for therapeutic brain stimulation in psychiatric disease.

Copyright © 2015 The Authors.

Published by Elsevier Ltd.. All rights reserved.

Publication Type Journal Article.

Research Support, Non-U.S. Gov’t. Review.