TY - JOUR
T1 - Task-related functional magnetic resonance imaging-based neuronavigation for the treatment of depression by individualized repetitive transcranial magnetic stimulation of the visual cortex
AU - Zhang, Zhijun
AU - Zhang, Hongxing
AU - Xie, Chun Ming
AU - Zhang, Meng
AU - Shi, Yachen
AU - Song, Ruize
AU - Lu, Xiang
AU - Zhang, Haisan
AU - Li, Kun
AU - Wang, Bi
AU - Yang, Yongfeng
AU - Li, Xianrui
AU - Zhu, Jianli
AU - Zhao, Yang
AU - Yuan, Ti Fei
AU - Northoff, Georg
PY - 2021/1
Y1 - 2021/1
N2 - To determine whether repetitive transcranial magnetic stimulation (rTMS) of the visual cortex (VC) provides effective and well-tolerated treatment and whether magnetic resonance imaging (MRI) measures functional change of the VC as a biomarker of therapeutic effect in major depressive disorder (MDD), we performed a sham-controlled, double-blind, randomized, three-arm VC rTMS treatment study in 74 MDD patients. Neuronavigated rTMS (10 Hz, 90% of resting motor threshold, 1,600 pulses over 20 min twice per day) was performed over the VC for five days. Clinical outcome was measured by Hamilton Depression Rating Scale (HAMD-24) at days 0, 1, 3, 5 and after terminating rTMS, with follow-up at four weeks. MRI was measured at days 0 and 5. The individualized group exhibited the greatest change in HAMD-24 scores after VC rTMS for 5 days (F=5.53, P=0.005), which were maintained during follow-up period (F=4.22, P=0.016). All patients reported good tolerance. Changes in VC task-related functional MRI correlated with symptomatic reduction in the individualized group. Treatment reduced the initially abnormal increase in resting state functional connectivity from the VC to the pre/subgenual anterior cingulate cortex at day 5, especially in the individualized group. We demonstrated therapeutic potential and good tolerance of VC rTMS in MDD patients, indicated by biomarkers of fMRI measurement.
AB - To determine whether repetitive transcranial magnetic stimulation (rTMS) of the visual cortex (VC) provides effective and well-tolerated treatment and whether magnetic resonance imaging (MRI) measures functional change of the VC as a biomarker of therapeutic effect in major depressive disorder (MDD), we performed a sham-controlled, double-blind, randomized, three-arm VC rTMS treatment study in 74 MDD patients. Neuronavigated rTMS (10 Hz, 90% of resting motor threshold, 1,600 pulses over 20 min twice per day) was performed over the VC for five days. Clinical outcome was measured by Hamilton Depression Rating Scale (HAMD-24) at days 0, 1, 3, 5 and after terminating rTMS, with follow-up at four weeks. MRI was measured at days 0 and 5. The individualized group exhibited the greatest change in HAMD-24 scores after VC rTMS for 5 days (F=5.53, P=0.005), which were maintained during follow-up period (F=4.22, P=0.016). All patients reported good tolerance. Changes in VC task-related functional MRI correlated with symptomatic reduction in the individualized group. Treatment reduced the initially abnormal increase in resting state functional connectivity from the VC to the pre/subgenual anterior cingulate cortex at day 5, especially in the individualized group. We demonstrated therapeutic potential and good tolerance of VC rTMS in MDD patients, indicated by biomarkers of fMRI measurement.
KW - functional magnetic resonance imaging
KW - individualized treatment
KW - major depressive disorder
KW - neuronavigated
KW - repetitive transcranial magnetic stimulation
KW - visual cortex
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U2 - 10.1007/s11427-020-1730-5
DO - 10.1007/s11427-020-1730-5
M3 - Article
AN - SCOPUS:85086436454
VL - 64
SP - 96
EP - 106
JO - Science China Life Sciences
JF - Science China Life Sciences
SN - 1674-7305
IS - 1
ER -