Anatomical and fMRI-network comparison of multiple DLPFC targeting strategies for repetitive transcranial magnetic stimulation treatment of depression
| Autor: | Jyoti Bhat, Brian J. Roach, A.M. Horwege, J Lavacot, Gary H. Glover, Deborah A. Yurgelun-Todd, Allyson C. Rosen, Jerome A. Yesavage, T.J. Ehrlich, Michael E. Thase, Mark S. George, Steven D. Forman, V.A. Cardenas, Daniel H. Mathalon, Bashar W. Badran |
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| Rok vydání: | 2021 |
| Předmět: |
TMS targeting
Post hoc medicine.medical_treatment Biophysics Prefrontal Cortex Neurosciences. Biological psychiatry. Neuropsychiatry Electroencephalography HCP atlas behavioral disciplines and activities Functional connectivity Depressive Disorder Treatment-Resistant Text mining Yeo atlas medicine Humans Depression (differential diagnoses) medicine.diagnostic_test business.industry Depression General Neuroscience Magnetic Resonance Imaging Transcranial Magnetic Stimulation Dorsolateral prefrontal cortex Transcranial magnetic stimulation medicine.anatomical_structure nervous system Scalp Posterior cingulate Neurology (clinical) business Neuroscience psychological phenomena and processes RC321-571 |
| Zdroj: | Brain Stimulation, Vol 15, Iss 1, Pp 63-72 (2022) Brain Stimulation, vol 15, iss 1 |
| ISSN: | 1876-4754 |
| Popis: | BACKGROUND: The efficacy of repetitive transcranial magnetic stimulation (rTMS) for depression may vary depending on the subregion stimulated within the dorsolateral prefrontal cortex (DLPFC). Clinical TMS typically uses scalp-based landmarks for DLPFC targeting, rather than individualized MRI guidance. OBJECTIVE: In rTMS patients, determine the brain systems targeted by multiple DLPFC stimulation rules by computing several surrogate measures: underlying brain targets labeled with connectivity-based atlases, subgenual cingulate anticorrelation strength, and functionally connected networks. METHODS: Forty-nine patients in a randomized controlled trial of rTMS therapy for treatment resistant major depression underwent structural and functional MRI. DLPFC rules were applied virtually using MR-image guidance. Underlying cortical regions were labeled, and connectivity with the subgenual cingulate and whole-brain computed. RESULTS: Scalp-targeting rules applied post hoc to these MRIs that adjusted for head size, including Beam F3, were comparably precise, successful in directly targeting classical DLPFC and frontal networks, and anticorrelated with the subgenual cingulate. In contrast, all rules involving fixed distances introduced variability in regions and networks targeted. The 5cm rule targeted a transitional DLPFC region with a different connectivity profile from the adjusted rules. Seed-based connectivity analyses identified multiple regions, such as posterior cingulate and inferior parietal lobe, that warrant further study in order to understand their potential contribution to clinical response. CONCLUSION: EEG-based rules consistently targeted DLPFC brain regions with resting-state fMRI features known to be associated with depression response. These results provide a bridge from lab to clinic by enabling clinicians to relate scalp-targeting rules to functionally connected brain systems. |
| Databáze: | OpenAIRE |
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