Intermittent theta-burst stimulation moderates interaction between increment of N-Acetyl-Aspartate in anterior cingulate and improvement of unipolar depression
| Autor: | Henning Rekate, Igor Nenadic, Patricia Dietsche, Tina Meller, Miriam Bopp, Maxim Zavorotnyy, Axel Krug, Jens Sommer, Rebecca Zöllner |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Choline-containing compounds medicine.medical_treatment Stimulation Choline 0302 clinical medicine Theta Rhythm Neurons General Neuroscience 05 social sciences Unipolar major depression Middle Aged N acetyl aspartate Transcranial Magnetic Stimulation medicine.anatomical_structure Major depressive disorder Antidepressant Female Adult medicine.medical_specialty Models Neurological Biophysics Prefrontal Cortex Gyrus Cinguli behavioral disciplines and activities 050105 experimental psychology Anterior cingulate cortex lcsh:RC321-571 03 medical and health sciences Neurochemical Internal medicine Neuroplasticity mental disorders N-Acetyl-aspartate medicine Humans 0501 psychology and cognitive sciences Non-invasive brain stimulation lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Proton magnetic resonance spectroscopy Aspartic Acid Depressive Disorder Major business.industry medicine.disease Transcranial magnetic stimulation Endocrinology nervous system Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Brain Stimulation, Vol 13, Iss 4, Pp 943-952 (2020) |
| Popis: | Background Intermittent theta-burst stimulation (iTBS), a novel repetitive transcranial magnetic stimulation (rTMS) technique, appears to have antidepressant effects when applied over left dorsolateral prefrontal cortex (DLPFC). However, its underlying neurobiological mechanisms are unclear. Proton magnetic resonance spectroscopy (1H-MRS) provides in vivo measurements of cerebral metabolites altered in major depressive disorder (MDD) like N-acetyl-aspartate (NAA) and choline-containing compounds (Cho). We used MRS to analyse effects of iTBS on the associations between the shifts in the NAA and Cho levels during therapy and MDD improvement. Methods In-patients with unipolar MDD (N = 57), in addition to treatment as usual, were randomized to receive 20 iTBS or sham stimulations applied over left DLPFC over four weeks. Single-voxel 1H-MRS of the anterior cingulate cortex (ACC) was performed at baseline and follow-up. Increments of concentrations, as well as MDD improvement, were defined as endpoints. We tested a moderated mediation model of effects using the PROCESS macro (an observed variable ordinary least squares and logistic regression path analysis modeling tool) for SPSS. Results Improvement of depressive symptoms was significantly associated with decrease of Cho/NAA ratio, mediated by NAA. iTBS had a significant moderating effect enhancing the relationship between NAA change and depression improvement. Conclusions Our findings suggest a potential neurochemical pathway and mechanisms of antidepressant action of iTBS, which may moderate the improvement of metabolic markers of neuronal viability. iTBS might increase neuroplasticity, thus facilitating normalization of neuronal circuit function. |
| Databáze: | OpenAIRE |
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