背外侧前额叶皮质
扣带回前部
心理学
脑岛
磁刺激
刺激
功能磁共振成像
抗抑郁药
神经科学
萧条(经济学)
静息状态功能磁共振成像
难治性抑郁症
默认模式网络
听力学
医学
重性抑郁障碍
前额叶皮质
认知
海马体
经济
宏观经济学
作者
Peter Stöhrmann,Godber Mathis Godbersen,Murray Bruce Reed,Jakob Unterholzner,Manfred Klöbl,P. Baldinger,Thomas Vanicek,Andreas Hahn,Rupert Lanzenberger,Siegfried Kasper,Georg S. Kranz
标识
DOI:10.1016/j.jad.2022.12.088
摘要
Previous studies suggest that transcranial magnetic stimulation exerts antidepressant effects by altering functional connectivity (FC). However, knowledge about this mechanism is still limited. Here, we aimed to investigate the effect of bilateral sequential theta-burst stimulation (TBS) on FC in treatment-resistant depression (TRD) in a sham-controlled longitudinal study. TRD patients (n = 20) underwent a three-week treatment of intermittent TBS of the left and continuous TBS of the right dorsolateral prefrontal cortex (DLPFC). Upon this trial's premature termination, 15 patients had received active TBS and five patients sham stimulation. Resting-state functional magnetic resonance imaging was performed at baseline and after treatment. FC (left and right DLPFC) was estimated for each participant, followed by group statistics (t-tests). Furthermore, depression scores were analyzed (linear mixed models analysis) and tested for correlation with FC. Both groups exhibited reductions of depression scores, however, there was no significant main effect of group, or group and time. Anticorrelations between DLPFC and the subgenual cingulate cortex (sgACC) were observed for baseline FC, corresponding to changes in depression severity. Treatment did not significantly change DLPFC-sgACC connectivity, but significantly reduced FC between the left stimulation target and bilateral anterior insula. Our data is compatible with previous reports on the relevance of anticorrelation between DLPFC and sgACC for treatment success. Furthermore, FC changes between left DLPFC and bilateral anterior insula highlight the effect of TBS on the salience network. Due to the limited sample size, results should be interpreted with caution and are of exploratory nature.
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