Identifying brain imaging correlates of clinical response to repetitive transcranial magnetic stimulation (rTMS) in major depression




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Details zur Publikation

Autorenliste: Soriano-Mas C
Verlag: Elsevier: 12 months
Jahr der Veröffentlichung: 2013
Zeitschrift: Brain Stimulation (1935-861X)
Bandnummer: 6
Heftnummer: 1
Erste Seite: 54
Letzte Seite: 61
Seitenumfang: 8
ISSN: 1935-861X
Sprachen: Englisch-Vereinigtes Königreich (EN-GB)


Partial response and non-response to treatments are common problems in
major depression. The identification of biological markers of clinical
response may be of special interest for some adjunctive treatments, such
as repetitive transcranial magnetic stimulation (rTMS), as it may
ultimately improve their cost-effectiveness.To identify pre-treatment
functional imaging correlates of clinical response to rTMS in major
depression.We evaluated 21 depressed patients. They were randomized to
receive 15 sessions of active or sham rTMS on the left dorsolateral
prefrontal cortex. Functional magnetic resonance imaging (fMRI) was used
to assess pre-treatment regional brain activity evoked by a word
generation task. These regional activations were correlated (voxel-wise)
with the Hamilton Rating Scale for Depression (HAM-D) reduction between
baseline and end of treatment. A group of 13 healthy controls was also
assessed using the same fMRI protocol to obtain reference imaging
measurements.At the end of treatment, the percentage of patients with a
HAM-D reduction greater than 50% was larger in the active than in the
sham rTMS group (70% vs. 27.3%). In the active rTMS group, larger HAM-D
reductions were significantly correlated with smaller deactivations
during pre-treatment fMRI assessment in the anterior cingulate, the left
medial orbitofrontal and the right middle frontal cortices, in addition
to larger activations in the left ventral-caudal putamen.These results
suggest that brain activity in regions arguably relevant for major
depression may predict clinical response to rTMS. This approach may help
in identifying the most suitable candidates to undergo rTMS treatment.


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Zuletzt aktualisiert 2019-13-08 um 00:45