Decreased salience network fMRI functional connectivity following a course of rTMS for treatment-resistant depression.
Brain networks
Functional magnetic resonance imaging
Major depressive disorder
Repetitive transcranial magnetic stimulation
Salience network
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 03 2022
01 03 2022
Historique:
received:
05
07
2021
revised:
08
11
2021
accepted:
30
12
2021
pubmed:
6
1
2022
medline:
5
3
2022
entrez:
5
1
2022
Statut:
ppublish
Résumé
Repetitive transcranial magnetic stimulation (rTMS) is a treatment shown to be effective in treating major depressive disorder (MDD). However, the effect of rTMS therapy on functional connectivity within the brains of patients being treated for MDD remains poorly understood. Few studies have investigated the effects of a course of rTMS on resting-state network activity. In an open-label naturalistic study, resting-state fMRI was collected prior to and following a four-week course of rTMS in 24 participants with MDD and 2 with bipolar disorder. Montgomery-Asberg depression rating scale scores showed a response rate of 42%. Clinical response to rTMS was correlated with reduced functional connectivity from baseline to post-rTMS within the salience network (SN). This indicates SN connectivity may be functionally relevant to how rTMS produces antidepressant effects. In an exploratory inter-network analysis, connectivity between the SN and posterior default mode network (pDMN) was higher following treatment. However this difference was not correlated with the antidepressant response. Local BOLD activity within these networks was also assessed using the fractional amplitude of low-frequency fluctuations (fALFF) technique. Local activity increased in both the SN and pDMN following rTMS. However this increase was also not correlated with antidepressant response. The sample population was heterogeneous, continuing current use of medications, and the study lacked a healthy control or sham stimulation comparison group. Together, these results provide evidence for the involvement of the SN in the antidepressant response to rTMS treatment.
Sections du résumé
BACKGROUND
Repetitive transcranial magnetic stimulation (rTMS) is a treatment shown to be effective in treating major depressive disorder (MDD). However, the effect of rTMS therapy on functional connectivity within the brains of patients being treated for MDD remains poorly understood. Few studies have investigated the effects of a course of rTMS on resting-state network activity.
METHODS
In an open-label naturalistic study, resting-state fMRI was collected prior to and following a four-week course of rTMS in 24 participants with MDD and 2 with bipolar disorder. Montgomery-Asberg depression rating scale scores showed a response rate of 42%.
RESULTS
Clinical response to rTMS was correlated with reduced functional connectivity from baseline to post-rTMS within the salience network (SN). This indicates SN connectivity may be functionally relevant to how rTMS produces antidepressant effects. In an exploratory inter-network analysis, connectivity between the SN and posterior default mode network (pDMN) was higher following treatment. However this difference was not correlated with the antidepressant response. Local BOLD activity within these networks was also assessed using the fractional amplitude of low-frequency fluctuations (fALFF) technique. Local activity increased in both the SN and pDMN following rTMS. However this increase was also not correlated with antidepressant response.
LIMITATIONS
The sample population was heterogeneous, continuing current use of medications, and the study lacked a healthy control or sham stimulation comparison group.
CONCLUSIONS
Together, these results provide evidence for the involvement of the SN in the antidepressant response to rTMS treatment.
Identifiants
pubmed: 34986371
pii: S0165-0327(21)01445-2
doi: 10.1016/j.jad.2021.12.129
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
235-242Informations de copyright
Copyright © 2022. Published by Elsevier B.V.