Enhancing neuroplasticity in major depression: A novel 10 Hz-rTMS protocol is more effective than iTBS.

Intermittend theta-burst stimulation (iTBS) Major depressive disorder (MDD) Neuroplasticity Paired associative stimulation (PAS) Repetitive transcranial magnetic stimulation (rTMS)

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
24 Aug 2024
Historique:
received: 11 03 2024
revised: 25 07 2024
accepted: 23 08 2024
medline: 27 8 2024
pubmed: 27 8 2024
entrez: 26 8 2024
Statut: aheadofprint

Résumé

Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment in major depressive disorder (MDD). However, intermittent theta-burst stimulation (iTBS) and rTMS protocols using 10 Hz stimulation frequency might differ in their effect on neuroplasticity and on clinical symptoms. This study compares the effect of iTBS and a novel 10 Hz-rTMS with shortened single session duration, on motor excitability and neuroplasticity and on clinical symptoms in MDD. 30 patients with MDD received either iTBS or the novel 10 Hz-rTMS daily over three weeks to the left dorsolateral prefrontal cortex. Before and after the interventions, motor excitability, short-latency intracortical inhibition and long-term-potentiation-like plasticity in the motor cortex and clinical symptoms were measured by use of transcranial magnetic stimulation. After the intervention, the level of neuroplasticity increased and clinical symptoms of depression were reduced in both groups, though both effects were significantly stronger after the novel 10 Hz-rTMS. Importantly, the changes in neuroplasticity and clinical symptoms were correlated: the stronger neuroplasticity increased, the stronger was the improvement of clinical symptoms. Short intervention period of 3 weeks. Clinical symptoms were measured by self-assessment only and are therefore preliminary. The novel 10 Hz-rTMS is more effective in increasing neuroplasticity in MDD and potentially also in reducing clinical symptoms than iTBS. This might be due to a differential mode of action on neuroplasticity and to the stimulation frequency of 10 Hz (within the alpha range) being more suitable to reset the brain's activity and to support neuroplastic changes.

Sections du résumé

BACKGROUND BACKGROUND
Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment in major depressive disorder (MDD). However, intermittent theta-burst stimulation (iTBS) and rTMS protocols using 10 Hz stimulation frequency might differ in their effect on neuroplasticity and on clinical symptoms. This study compares the effect of iTBS and a novel 10 Hz-rTMS with shortened single session duration, on motor excitability and neuroplasticity and on clinical symptoms in MDD.
METHODS METHODS
30 patients with MDD received either iTBS or the novel 10 Hz-rTMS daily over three weeks to the left dorsolateral prefrontal cortex. Before and after the interventions, motor excitability, short-latency intracortical inhibition and long-term-potentiation-like plasticity in the motor cortex and clinical symptoms were measured by use of transcranial magnetic stimulation.
RESULTS RESULTS
After the intervention, the level of neuroplasticity increased and clinical symptoms of depression were reduced in both groups, though both effects were significantly stronger after the novel 10 Hz-rTMS. Importantly, the changes in neuroplasticity and clinical symptoms were correlated: the stronger neuroplasticity increased, the stronger was the improvement of clinical symptoms.
LIMITATIONS CONCLUSIONS
Short intervention period of 3 weeks. Clinical symptoms were measured by self-assessment only and are therefore preliminary.
CONCLUSIONS CONCLUSIONS
The novel 10 Hz-rTMS is more effective in increasing neuroplasticity in MDD and potentially also in reducing clinical symptoms than iTBS. This might be due to a differential mode of action on neuroplasticity and to the stimulation frequency of 10 Hz (within the alpha range) being more suitable to reset the brain's activity and to support neuroplastic changes.

Identifiants

pubmed: 39187195
pii: S0165-0327(24)01400-9
doi: 10.1016/j.jad.2024.08.166
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest There are no competing interests.

Auteurs

Sebastian Scho (S)

Ruhr-University of Bochum, Medical faculty, University clinic for psychiatry and psychotherapy, Campus East-Westphalia, Virchowstraße 65, 32312 Lübbecke, Germany.

Wanja Brüchle (W)

Ruhr-University of Bochum, Medical faculty, University clinic for psychiatry and psychotherapy, Campus East-Westphalia, Virchowstraße 65, 32312 Lübbecke, Germany.; Departmenf of Intensive Care and Emergency Medicine, St. Franziskus-Hospital Münster, Hohenzollernring 72, Münster, Germany.

Jessica Schneefeld (J)

Ruhr-University of Bochum, Medical faculty, University clinic for psychiatry and psychotherapy, Campus East-Westphalia, Virchowstraße 65, 32312 Lübbecke, Germany.

Karin Rosenkranz (K)

Ruhr-University of Bochum, Medical faculty, University clinic for psychiatry and psychotherapy, Campus East-Westphalia, Virchowstraße 65, 32312 Lübbecke, Germany.; Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany; ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany. Electronic address: Karin.Rosenkranz@medicalschool-hamburg.de.

Classifications MeSH