Preliminary Research on Depression Treatment: Combination of Transcranial Magnetic Stimulation and MRI-Guided Low-Intensity Focused Ultrasound Pulsation

Depression (major depressive disorder) is a common but serious mood disorder. When traditional medication treatment does not reduce symptoms, transcranial magnetic stimulation (TMS) has been approved by the Food and Drug Administration (FDA), neuromodulation has become increasingly relevant to clinical research. However, TMS has significant drawback in the lack of depth and special specificity. In the last few years low-intensity focused ultrasound pulsation (LIFUP) has been used to be focused noninvasively through the skull anywhere within the brain, together with functional magnetic resonance imaging (fMRI) guided techniques, LIFUP can be applied to deep structures with greater spatial precision. In this manuscript, combination of TMS and fMRI-guided LIFUP on the treatment of depression was proposed to achieve the benefits of both. The data of the combined methods demonstrate significantly better clinical results in comparison to the control group, as measured by the Hamilton Rating Scale for Depression (HAM-D) scale, Geriatric Depression scale (GDS) and the Pittsburgh Sleep Quality Index (PSQI) with low adverse reaction.