Subcallosal Cingulate Deep Brain Stimulation and Heart Rate Variability in Treatment-Resistant Depression: Evidence for Person-Specific Autonomic Phenotypes

Martijn Figee; Jacob Francis Dahill-Fuchel; Allison Waters; Christopher Rozell; Richard Lane; Helen Mayberg; John JB Allen; Elisa Xu; Jacqueline Overton; Patricio Riva Posse; Tanya Nauvel

Subcallosal Cingulate Deep Brain Stimulation and Heart Rate Variability in Treatment-Resistant Depression: Evidence for Person-Specific Autonomic Phenotypes

PsyArXiv (OSF Preprints) 2026 Preprint Open access

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Authors: Martijn Figee, Jacob Francis Dahill-Fuchel, Allison Waters, Christopher Rozell, Richard Lane, Helen Mayberg, John JB Allen, Elisa Xu, Jacqueline Overton, Patricio Riva Posse, Tanya Nauvel

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Abstract

Subcallosal cingulate (SCC) deep brain stimulation (DBS) is an established intervention for treatment-resistant depression (TRD) that modulates white-matter tracts within the central autonomic network (CAN). In eight patients with TRD, SCC DBS produced robust antidepressant effects but no group-level change in heart-rate variability (HRV), a marker of vagal flexibility. However, patients whose mood and HRV covaried over time showed greater HRV improvement, suggesting that SCC DBS enhances autonomic flexibility only in individuals with intact mood–vagal coupling.

Fields of Study & Subjects

Vagus Nerve Stimulation Research Neurological disorders and treatments Transcranial Magnetic Stimulation Studies

Publication details

Journal / source: PsyArXiv (OSF Preprints)
Publication date: 7 April 2026
Document type: Preprint