Application of Multichannel Electrical Stimulation of the Neck

Nervous Structures in Patients with Depressive Disorders:

An fMRI Case Study

Vladimir Kublanov

, Timur Petrenko

and Aleksandr Efimtcev

Ural Federal University, Mira 19, Yekaterinburg, Russian Federation

The Almazov National Medical Research Centre, St. Petersburg, Russian Federation

Keywords: Neuro-electrostimulation, Neuroimaging, functional MRI, Depression Disorder.

Abstract: The article presents the pilot functional neuroimaging study results of the treatment process by means

neuro-electrostimulator SYMPATHOCOR-01 in patients with depressive disorder. The study involved three

patients. The changes in the brain's default mode network (DMN) as a result of neuro-electrostimulation

course are demonstrated. Along with clinical improvement (HDRS-21 and BDI-II scales), changes in

DMN's performance from neuroimaging data are shown. An increase in the medial prefrontal cortex and

cingulate gyrus functional connection activity with various parts of the brain was noted. These changes

indicate the activation of neuroplasticity processes and restoring the work of DMN in patients with

depression.

1 INTRODUCTION

The rapid spread of depressive disorder among the

working-age population of developed countries

determines the relevance of the search for effective

treatment and rehabilitation approaches o this

disease. It is known that depressive disorder occurs

at any age, acutely limiting a person’s adaptation to

changing environment. In the European Union the

depression came in first place among causes of the

able-bodied life years loss. The direct and indirect

economic losses associated with this disorder exceed

300 billion euros per year. (Research Institute of

Scientific and Technological Information, 2014)

Modern neurophysiological studies have

discovered the most important role of impaired

neurotrophic regulation processes in the

pathogenesis of depressive disorder (Licznerski and

Duman, 2013). There was a marked decrease frontal

cortex activity - responsible for analytical functions

and decision making (Bremner et al., 2002; Cotter et

al., 2001); hippocampus and amygdala -

participating in the processes of learning and

memory, emotional response (Rajkowska et al.,

2001; Sheline, 2003); autonomic centers of the brain

stem - regulating the work of the internal organs,

circadian processes and neurogenesis

activity (Khalsa SBS et al., 2000).

Neuroplasticity is a combination of multi-level

processes of continuous morphofunctional

reorganization of the brain, thus providing

adaptation to changing external and internal

conditions. The most studied of the processes of

neuroplasticity are the processes of neurotrophic

regulation. The actions of neurotrophic factors are

explained through the activation of genetically

programmed regulation mechanisms impacting to

nervous tissue. In the case of depression, we are

talking about damage of the basic neuroplasticity

processes, as evidenced by numerous studies (Doan

et al., 2015; Kraus et al., 2017; Liu et al., 2017).

Today to get a new knowledge about brain

potential possibilities and search the effective

methods of stimulating neuroplasticity processes a

priority task of the basic sciences in all developed

countries.

A modern medical approach to the treatment of

depressive disorder is aimed at regulating synaptic

transmission processes due to indirect increase

activity of certain neurotransmitters (such as

serotonin, norepinephrine and dopamine). As

clinical practice shows, this approach has poor

effectiveness. Only one third of patients with

depressive disorder respond to antidepressant

therapy (Culpepper et al., 2015).

564

Kublanov, V., Petrenko, T. and Eﬁmtcev, A.

Application of Multichannel Electrical Stimulation of the Neck Nervous Structures in Patients with Depressive Disorders: An fMRI Case Study.

DOI: 10.5220/0007681705640571

In Proceedings of the 12th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2019), pages 564-571

ISBN: 978-989-758-353-7

Innovative approaches involved neuroplasticity

processes is more effective, because of affecting to

pathological mechanisms accompanying depression.

Modulation of neurotrophic regulation makes it

possible to influence to electrochemical transmission

of nerve impulses and activate the process of

neuroprotection (Malykhin and Coupland, 2015).

Emergence of the modern neurovisualization

methods opens the possibilities in the neuroplasticity

investigation. Functional magnetic resonance

imaging (fMRI), which is an intravital non- invasive

dynamic investigation of active brain structures

during their functioning.

The purpose of the study is to identify brain

functional changes in treatment depressive disorder

patients by the SYMPATHOCOR-01 device by

means of fMRI. Results, presented in the study are

an extended version of previously published case

study (Kublanov et al., 2018).

The SYMPATHOCOR-01 neuro-

electrostimulation device is essentially the

technology of multi-channel neuro-

electrostimulation by means of a spatially distributed

physical field (Kublanov et al., 2012).

The device is included in the register of medical

equipment products of the Russian Federation

(registration certificate № FCR 2007/00757) and has

the Certificate of correspondence to the

requirements of the regulations GOST R 50444-92.

The spatially-distributed field of the current

pulses is formed between two multi-element

electrodes of the device. Each multi-element

electrode comprises a cluster of thirteen partial

current-conducting elements. The multi-element

electrodes are arranged on the neck into left and

right sides. In the working state, one element of one

multi-element electrode performs the role of the

anode. Elements on the other side become the

cathodes.

A feature of the extension in current work is the

implementation of the multifactorial nature of neuro-

electrostimulation due to the realization of the

possibility to change the field structure, the

stimulation target and to choose bio-tropic

parameters of current pulses, adequate to the

anatomical location of the stimulation targets.

Figure 1: Scheme of the partial current-conducting

elements of the multi-element electrodes location.

Placing the multi-element electrodes on the

subject neck, the central elements of multi-element

electrodes have to be located in projections of the

neck ganglia of the sympathetic nervous system

targets (Fig. 1).

Note the following basic bio-tropic

characteristics of the field: the current partial pulses

duration τ is from 15 to 60 usec. The frequency f of

pulses group is from 5 to 150 Hz. The cathode

elements are switched accordingly to each given rule

(for example, a pseudo-random with the clockwise

or counterclockwise direction of switching, and so

on). The used anode is set depending on the

stimulation target. In this work upper and middle

neck ganglia of the sympathetic nervous system are

used as the target. The duration of the anode

connection varies from 30 seconds to several

minutes and is controlled by the physician. The

current pulses amplitude can be up to 15 mA.

The treatment application of the neuro-

electrostimulation device is implemented as the

DCASNS technique (Dynamic Correction of the

Sympathetic Nervous System Activity) (Kublanov et

al., 2014). The DCASNS technique provides

correction of autonomic balance, which is

characterized by the ratio between the sympathetic

and parasympathetic departments of the autonomic

nervous system (ANS) (Kublanov et al., 2017).

2 MATERIAL AND METHODS

Depending on pathogenesis of the peripheral or

central dysfunctions of the ANS, the dynamic

correction of the activity sympathetic nervous

system (DCASNS) algorithm has two different

branches. Decision of which branch should be

executed is based on nature of the ANS dysfunction.

The bio-tropic parameters of the implemented

current pulse field (the field structure, pulses

amplitude, frequency, and duration) are calculated

from the analysis of the heart rhythm variability. In

particular, in the case of the abnormal hyperactivity

of sympathetic innervation, it is necessary to block

or suppress the activity of the sympathetic nervous

system. In contrast, sympathetic innervation should

be increased, if the hyperactivity of the

parasympathetic innervation is observed. In case of

central dysfunctions, the bio-tropic parameters of the

stimulation field are calculated, based on analysis of

the main activity rhythms of the cerebral cortex and

its deviation from the norm.

In clinic practice, the ‘SYMPATHOCOR-01’

device and DCASNS algorithm were efficiently

Application of Multichannel Electrical Stimulation of the Neck Nervous Structures in Patients with Depressive Disorders: An fMRI Case

Study

565

applied for treatment of various diseases including

organic and/or functional disorders of the CNS

and/or the ANS: consequences of brain trauma or

stroke, epilepsy, chronic headache, somatoform

disorders, anxiety and depressive spectrum

disorders, attention- deficit hyperactivity disorder,

disorders involving cognitive impairments

(Kublanov et al., 2017).

In the December of 2017, at the State Scientific-

Research Institute of Physiology & Basic Medicine

(SSRI PBM), the pilot study of the hemodynamic

reactions, caused by the neuronal activity of the

brain, by means of the rfMRI, was conducted.

The study was conducted with the approval of

the Research Institute of Biomedical Ethics SSRI

PBM. Protocol of the local ethical committee # 13

dated 16.11.2017.

Three patients diagnosed with ICD F33 have

participated in this pilot study. The patients have

signed the informative participation consent. The

study was carried out on the MR system GE

Discovery MR750W, 3.0 Tesla, in accordance with

the following protocols:

T1 SPGR 3D reconstruction, up to 256 cross-

sections, voxel size 1 mm3; mandatory capturing the

whole head surface, including nose and ears;

fMRI in the resting state mode (33 cross-

sections, thickness up to 4,5 mm)

T2-WI, FLAIR (weighted images for exclusion

of the chronic gliosis sources). The stimuli were

send by means of the Nordic NeuroLab BrainEx.

For registration to standard space a T1 high-

resolution 3D MPRAGE (magnetization prepared

rapid gradient echo) was performed. with the

following scan parameters: repetition time (TR) = 2.5

s, echo time (TE) = 3.52 ms, 190 sagittal slices with

no gap, field-of-view (FoV) = 230 mm, flip angle

(FA) = 8°, in-plane resolution = 1.2×1.2 mm2, slice

thickness = 1.2 mm. During RS-fMRI acquisition,

using gradient echo T2* weighted EPI, participant

was instructed to keep the eyes closed and not to

think about anything. The imaging parameters were:

100 volumes, TR = 3000 ms, TE = 52 ms, FA = 90°,

33 interleaved slices, slice thickness = 4,5 mm,

imaging matrix 64×64 and FoV = 220 mm. The study

timeline is presented in the table 1.

Table 1: Study timeline.

I phase II phase

-T1-sag

-RS

-Visual Nordic

-DTI

-MRA

-T1-sag

-RS

-Visual Nordic

-DTI

-MRA

Here: T1-sag – weighted image in the sagittal

projection; RS - resting state functional MRI (BOLD

signal); MRA - MR-angiography, a medical test that

helps physicians diagnose and treat medical

conditions and diseases of the blood vessels.

The first phase was conducted before treatment

for the baseline state evaluation. The second phase

was conducted 5 days after 5 procedures of the

DCASNS, and in order to evaluate long term

reaction of the CNS.

The biotropic field features of the

SYMPATHOCOR-01 were set in accordance with

the DCASNS technique. There were one 15-minutes

procedure every day.

Our research team has experience in processing

and analyzing neuroimaging data in similar clinical

tasks (Efimtsev et al., 2014; Shelepin et al., 2018;

Sokolov et al., 2017; Trufanov et al., 2016).

Statistical analysis of data and evaluation of the

results of neuroimaging studies, as well as

individually or in group totally (resting state fMRI

data), were performed using CONN v.18 software

package (Functional connectivity Toolbox),

designed to determine the relationships between

different brain regions, including dynamic mode,

connectivity mapping, determining the structure of

various resting state networks and functional

networks of the brain.

This tool enables voxel correlation analysis

(communication between voxel groups) by plotting

the time dependencies between the BOLD signal

from a given voxel / group of voxels and each voxel

in the scan area. Many types of data are used for

processing. We used the analysis based on the

regions of interest measures (ROI-to-ROI), because

it corresponds to our main goal, is suitable for

performing individual analysis and provides a visual

graphical (and quantitative) representation in the

form of brain functional connectivity maps. For a

ROI-based analysis, Medial Prefrontal Cortex was

chosen as a seed ROI, as it is considered a part of

default mode network (DMN).

Evaluation of clinical status of patient was

performed twice - before and after the course of

neuroelectrostimulation. Clinical assessment was

supplemented by symptom scores on psychometric

scales: Beck Depression Inventory (BDI-II) (Beck et

al., 1996), Hamilton Depression Rating Scale

(HDRS-21) (Hamilton, 1960). During the study,

patients did not take any additional antidepressant

therapy.

NNSNT 2019 - Special Session on Non-invaisive Neuro-stimulation in Neurorehabilitation Tasks

566

3 RESULTS

The data of clinical dynamics, assessment of

psychometric scales and fMRI analysis of research

are given. At the end of the section the group

analysis data is represented.

Abbreviations: PFC - positive functional

connectivity; NFC - negative functional

connectivity; MPFC — Medial Prefrontal Cortex;

PCC - posterior cingulum; BA – Brodmann area

Patient No. 794., Male, 28 years. Diagnosis:

recurrent depressive disorder of the current severe

episode (F33.2).

Table 2: Psychometric scales dynamics.

BDI-II HDRS-21

Before Afte

51 32 28 6

Before treatment, there were obvious signs of

depression, visible in appearance, even by a non-

expert. Noticeable inhibition and unproductive

thinking and motor activity. The content of thinking

is the experience of failures and mistakes of life,

excessive concern for health. Serious sleep

disorders.

After treatment – all indicators are in the normal

range, except the motivation to work.

In patient 794 in 2 phase, the following changes

were identified in comparison to 1 phase (before

stimulation):

- “normalization” of the DMN, which was

expressed in the presence of all arear of

activation, usually detected in healthy subjects.

- recovery of positive FCs of the medial prefrontal

cortex with the left lower temporal gyrus,

anterior cingulum, left angular gyrus, right

postcentral gyrus, precuneus, right middle frontal

gyrus, right upper frontal gyrus, the left caudate;

- the change in the localization of negative FC of

the medial prefrontal cortex: FC with the lateral

occipital cortex bilaterally, the left temporal lobe,

the left medial frontal gyrus appeared, FCs with

opercular cortex, thalamus, insula disappeared

(Fig. 2).

Before Treatment: symptoms of depression are

determined by appearance. Expresses ideas of guilt

and meaninglessness of his life. Severe insomnia.

Feelings of powerlessness and lethargy. Pronounced

fluctuations in mood throughout the day and

alarming concerns about the state of their health.

After Treatment: depressive symptoms are detected

only with the active questioning of the patient.

Sleeping has improved significantly, and anxiety has

almost disappeared. Activity and cheerfulness

appeared.

Figure 2: Patient 794. Resting state fMRI maps – before

treatment (a), after treatment (b) show the changes in the

default brain network (p <0.001).

Patient No. 889. Woman, 53 years. Diagnosis:

recurrent depressive disorder current episode

average (F33.1).

Table 3: Psychometric scales dynamics.

BDI-II HDRS-21

Before Afte

38 27 17 5

In patient 889, before stimulation, the functional

connectivity of the MPFC was distributed as

follows:

- expressed negative FCs predominantly in the left

hemisphere with temporal lobes (middle and

superior temporal gyri), right thalamus,

hippocampus and putamen, left pre- and

postcentral gyri, parietal region (BA5, BA7);

- positive FCs with anterior and orbital parts of the

frontal lobes, and with the precentral cortex

Application of Multichannel Electrical Stimulation of the Neck Nervous Structures in Patients with Depressive Disorders: An fMRI Case

Study

567

(BA4), and the visual cortex

After stimulation, the DMN was represented as

“normal”:

- negative FSs symmetrically with the frontal

cortex (BA6, BA8, BA9), with the parietal

region (BA5, BA7) became significantly weaker,

but the lateralization of the remaining FCs was

still present (in the left hemisphere)

- appeared (recovered) positive FCs with posterior

cingulum, angular gyri, right middle and superior

temporal gyrus, hippocampus. At the same time,

the positive FCs with basal ganglia, putamen,

caudate, right insula, paracingular was preserved.

In this way, this patient had a rather expressed

dynamics, both according to HDRS-21, and

according to rfMRI, which demonstrated almost

complete “stabilization” of DMN (Fig. 3).

Figure 3: Patient 889. Statistical maps of post-processing

of resting state fMRI: before treatment (a), after treatment

(b) show the changes of functional connectivity in default

mode network (p <0.001).

Patient No. 865., Female, 54 years. Diagnosis:

recurrent depressive disorder current episode

average (F33.1).

Table 4: Psychometric scales dynamics.

BDI-II HDRS-21

Before Afte

13 11 17 6

Before treatment: pronounced signs of

depression during patient questioning. Severe

insomnia in all stages of sleep. Loss of interest in the

environment. Inhibition of thought and speech.

Alarming concerns about your health.

After treatment: no depressive statements; no

insomnia; active talks about inner state; there was a

feeling of unreality and automaticity of what is

happening (depersonalization).

Figure 4: Patient 865. Statistical maps of resting state

fMRI - before treatment (a), after treatment (b) show the

changes of functional connectivity in default mode

network (p <0.001).

In patient 865, who had a less expressed degree

of depression (on the Hamilton scale) and,

accordingly, insignificant dynamics after treatment,

the appearance of positive FCs with bilateral angular

gyri, lateral occipital cortex, bilateral fusiform gyri.

Negative FCs remained unchanged at all time points.

It should be noted that in this subject the cerebral

NNSNT 2019 - Special Session on Non-invaisive Neuro-stimulation in Neurorehabilitation Tasks

568

papillary at one time point was characterized by

functional connections that are close to “normal”,

although they were less expressed (Fig. 4).

The results of the comparative analysis (phase 2

> phase 1) in Fig. 5 and tab. 5.

Figure 5: Comparative group analysis of the functional

connectivity of the brain in subjects before the beginning

of rehabilitation and after completing the full course of

rehabilitation: 2D statistical map (a), 3D statistical map

reconstruction (b) (p <0.005).

Table 5: Resting-State fMRI in the group of patients with

depressive disorder in comparison with the data after the

course of rehabilitation.

Brain region T Voxels Volume MNI coordinats

Cerebelum 3

(left hemisphere)

-3.62 59 472 (-9; -37; -19)

Cerebelum 3

(right hemisphere)

-2.95 95 760 (12; -35; -19)

Occipital Fusiform

Gyrus Lef

2.53 210 1680 (-27; -77; -14)

(Precuneous)

Precuneous Cortex

2.38 202 1616 (1; -59; 38)

Lateral Occipital

Cortex, inferior

division Righ

2.27 358 2864 (46; -74; -02)

Vermis 3 -2.17 99 792 (1; -40; -11)

4 DISCUSSION

Summarizing the results obtained, it can be said that

the dynamics of changes using rfMRI confirms the

clinical dynamics, which is even more expressed

than more serious initial condition of the patient. In

many publications, the authors talk about changes in

the stability and variability of the functioning of the

DMN, especially its main parts - the MPFC and

PCC, which are involved in realization of deep

cognitive functions, a complex analysis of both the

surrounding and inner human world.

The correlation of the functional connections of

these areas among themselves, as well as with other

parts of the brain and the severity of depression, was

determined. Considering the brain DMN, in all the

patients in the Stimulation group it was

“normalized” - due to the restoration of the main

positive FCs between MPFC, PCC and angular gyri.

In all patients in the “Stimulation” group, before

treatment, the fMRI-pattern was characterized by

complete “instability” of DMN, with a

predominance of negative FCs. Some scientists talk

about changes in local connectivity in the frontal

lobes. Such a phenomenon may occur, for example,

in patient 889, in whom positive FCs were strongly

expressed in these areas. These activation patterns

can be considered as a mechanism of hyper-

compensation in response to an episode of

depressive disorder, as well as FCs with the parietal

region - as a predictor of episode relapse.

Some patients showed changes in the FCs of the

hippocampus and insular cortex with MPFC.

According to many authors, the function of these

areas, incl. as part of the limbic system, changes in

depressive disorders, demonstrating reduced

connectivity. It is known that these brain structures

contribute in the formation of the emotional

background, which can thus explain their main role

in the mechanisms of development of a deep

depressive disorder, including the early stages.

Patient 865 had a feeling of unreality and

automaticity of what is happening

(depersonalization) probably reflected by more

expressed negative FCs between MPFC and insula

on the right, as well as increased local positive FCs

between MPFC and ventrolateral prefrontal cortex

(right and left). The involvement of these brain areas

Application of Multichannel Electrical Stimulation of the Neck Nervous Structures in Patients with Depressive Disorders: An fMRI Case

Study

569

in the depressive process is reflected in some

research.

5 CONCLUSIONS

In the course of 5 procedures of neuro-

electrostimulation using SIMPATHOCOR, the

restoration of MPFC and PCC connectivity was

noted in these three patients, which brought their

DMN to the “normal state”. However, the

conclusion must be coordinated with the initial state

of the DMN, which has variable individual

characteristics. This fact must be considered in

further similar studies in large groups.

The important point noted in the course of the

study is the fact that the “normalization” of the

DMN appeared the stronger, the more severe the

symptoms were observed in the patient. This

indicates the use of the most powerful mechanisms

of neuroplasticity, which are being "turned on" after

neuro-electrostimulation.

ACKNOWLEDGEMENTS

This data acquisition within the study (Chapter 3)

was supported by the Act 211 of the Government of

the Russian Federation (contract no.

02.A03.21.0006). Data processing (Chapter 4) was

funded by RFBR (project no, 18-29-02052).

Authors are grateful to all staff of SIRBPM who

participated in the organization of research. Special

thanks to Maria Rezakova for her help in obtaining

fMRI signals.

REFERENCES

Beck, A.T., Steer, R.A., Ball, R., Ranieri, W., 1996.

Comparison of Beck Depression Inventories -IA and -

II in psychiatric outpatients. J Pers Assess 67, 588–

597.

Bremner, J.D., Vythilingam, M., Vermetten, E., Nazeer,

A., Adil, J., Khan, S., Staib, L.H., Charney, D.S.,

2002. Reduced volume of orbitofrontal cortex in major

depression. Biol. Psychiatry 51, 273–279.

Cotter, D., Mackay, D., Landau, S., Kerwin, R., Everall, I.,

2001. Reduced glial cell density and neuronal size in

the anterior cingulate cortex in major depressive

disorder. Arch. Gen. Psychiatry 58, 545–553.

Culpepper, L., Muskin, P.R., Stahl, S.M., 2015. Major

Depressive Disorder: Understanding the Significance

of Residual Symptoms and Balancing Efficacy with

Tolerability. Am. J. Med. 128, S1–S15.

Doan, L., Manders, T., Wang, J., 2015. Neuroplasticity

underlying the comorbidity of pain and depression.

Neural Plast. 2015, 504691.

Kublanov, V., Dolganov, A., Aftanas, L., Petrenko, T.,

Danilenko, K., Maria, R., Efimtcev, A., Babich, M.,

Sokolov, A., 2018. Investigation of the Neuro-

electrostimulation Mechanisms by Means of the

Functional MRI: Case Study. In: Proceedings of the

11th International Joint Conference on Biomedical

Engineering Systems and Technologies - Volume 3:

NENT (BIOSTEC 2018). Presented at the Special

Session on Neuro-electrostimulation in

Neurorehabilitation Tasks, pp. 319–324.

Efimtsev, A., Fokin, V., Sokolov, A., Voronkov, L.,

Trufanov, A., 2014. Morphometric Basis of

Depression in Parkinson’s Disease and the Possibility

of Its Prediction. In: Ślȩzak, D., Tan, A.-H., Peters,

J.F., Schwabe, L. (Eds.), Brain Informatics and

Health, Lecture Notes in Computer Science. Springer

International Publishing, pp. 357–365.

Hamilton, M., 1960. A rating scale for depression. J.

Neurol. Neurosurg. Psychiatry 23, 56–62.

Khalsa SBS, null, Jewett, M.E., Duffy, J.F., Czeisler,

C.A., 2000. The timing of the human circadian clock

is accurately represented by the core body temperature

rhythm following phase shifts to a three-cycle light

stimulus near the critical zone. J. Biol. Rhythms 15,

524–530.

Kraus, C., Castrén, E., Kasper, S., Lanzenberger, R., 2017.

Serotonin and neuroplasticity - Links between

molecular, functional and structural pathophysiology

in depression. Neurosci Biobehav Rev 77, 317–326.

Kublanov, V., Babich, M., Dolganov, A., 2017. Principles

of Organization and Control of the New

Implementation of the “SYMPATHOCOR-01” Neuro-

electrostimulation Device. Presented at the Special

Session on Neuro-electrostimulation in

Neurorehabilitation Tasks, pp. 276–282.

Kublanov, V., Shmirev, V., Shershever, A., Kazakov, Y.,

Porshnev, S., Vasilev, A., 2014. About innovative

possibilities of the device SIMPATOCOR in

management of functional disorders of vegetative and

central nervous system in neurology. Kremljovskaya

Medicina 1, 60–64.

Kublanov, V.S., Porshnev, S.V., Danilova, I.G., Goette,

I.F., Levashkina, A.O., Syskov, A.M., 2012.

Experimental modeling of the effects of autonomic

regulation in the correction of immobilization stress

rats. Biomedical Radioelectronics 56–67.

Licznerski, P., Duman, R.S., 2013. Remodeling of axo-

spinous synapses in the pathophysiology and treatment

of depression. Neuroscience 251, 33–50.

Liu, W., Ge, T., Leng, Y., Pan, Z., Fan, J., Yang, W., Cui,

R., 2017. The Role of Neural Plasticity in Depression:

From Hippocampus to Prefrontal Cortex. Neural

Plasticity 2017, 1–11.

Malykhin, N.V., Coupland, N.J., 2015. Hippocampal

neuroplasticity in major depressive disorder.

Neuroscience 309, 200–213.

NNSNT 2019 - Special Session on Non-invaisive Neuro-stimulation in Neurorehabilitation Tasks

570

Rajkowska, G., Halaris, A., Selemon, L.D., 2001.

Reductions in neuronal and glial density characterize

the dorsolateral prefrontal cortex in bipolar disorder.

Biol. Psychiatry 49, 741–752.

Research Institute of Scientific and Technological

Information, 2014. Public analytical report on the

direction of “Neurotechnology.”

Shelepin, K.Y., Trufanov, G.E., Fokin, V.A., Vasil’ev,

P.P., Sokolov, A.V., 2018. Digital visualization of the

activity of neural networks of the human brain before,

during, and after insight when images are being

recognized. J. Opt. Technol., JOT 85, 468–475.

Sheline, Y.I., 2003. Neuroimaging studies of mood

disorder effects on the brain. Biol. Psychiatry 54, 338–

352.

Sokolov, A.V., Vorobyev, S.V., Efimtcev, A.Y., Dekan,

V.S., Trufanov, G.E., Lobzin, V.Y., Fokin, V.A.,

2017. fMRI and Voxel-based Morphometry in

Detection of Early Stages of Alzheimer’s Disease: In:

Proceedings of the 10th International Joint

Conference on Biomedical Engineering Systems and

Technologies. Presented at the 4th International

Conference on Bioimaging, SCITEPRESS - Science

and Technology Publications, Porto, Portugal, pp. 67–

71.

Trufanov, A.G., Litvinenko, I.V., Odinak, M.M.,

Voronkov, L.V., Khaimov, D.A., Efimzev, A.Y.,

Fokin, V.A., 2016. Cortical cerebral atrophy in

patients with Parkinson’s disease: New opportunities

for in vivo diagnostics. Hum Physiol 42, 905–909.

Application of Multichannel Electrical Stimulation of the Neck Nervous Structures in Patients with Depressive Disorders: An fMRI Case

Study

571