State-dependent responses to intracranial brain stimulation in a patient with depression

Deep brain stimulation is a promising treatment for severe depression, but lack of efficacy in randomized trials raises questions regarding anatomical targeting. We implanted multi-site intracranial electrodes in a severely depressed patient and systematically assessed the acute response to focal electrical neuromodulation. We found an elaborate repertoire of distinctive emotional responses that were rapid in onset, reproducible, and context and state dependent. Results provide proof of concept for personalized, circuit-specific medicine in psychiatry. Acute mapping of responses to focal electrical neuromodulation in a patient with treatment-resistant depression reveals distinct mood and symptom changes that are highly context dependent.