Rewarding Network Mechanism of Left Orbito-frontal Cortex Transcranial Magnetic Stimulation in Depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S142-S143
Author(s):  
Q. Dai ◽  
Y. Xuntao ◽  
F. Zhengzhi

ObjectiveThe difficulties in the clinical antidepressant treatment lead to the pursuing of more effective methods such as transcranial magnetic stimulation (TMS). Mixed findings from DLPFC targeted TMS result in the exploration of optimal stimulation location. Disturbed function of obitofrontal cortex (OFC) has been indicated in depression, which is involving in the remission of depression. However, whether it could be a more specific treating target is not tested. Simultaneously, disturbed reward network (RN) has been confirmed in depression, however, whether this could be improved by TMS treatment remains unclear.MethodsFourteen patients with major depressive disorder (MDD) were allocated in a four-week course of OFC targeted TMS. Motivated by the literature, before and after the treatment, the function connectivity of RN with the seed of ventral striatum was conducted. The results were also compared with the data from 33 healthy controls.ResultsThe OFC targeted TMS improved the clinical depression significantly and enhanced the function connectivity within the RN effectively. Specifically, lower baseline dorsolateral striatum connectivity predicted strong therapeutic effect of TMS on depression, while lower baseline insula connectivity predicted weak therapeutic effect on depression.ConclusionsThe findings offer the first experimental evidence of the therapeutic effect of OFC targeted TMS on clinical depression, enhanced function connectivity within RN might be the potential neural mechanism (Fig. 1). Lower dorsolateral striatum connection might be a reliable neural biomarker of strong responding for TMS treatment, which helps to identify the patients who will be cured by TMS most effectively.

2021 ◽  
Vol 5 ◽  
pp. 247054702110068
Author(s):  
Cheng-Ta Li ◽  
Chih-Ming Cheng ◽  
Chi-Hung Juan ◽  
Yi-Chun Tsai ◽  
Mu-Hong Chen ◽  
...  

Background Prolonged intermittent theta-burst stimulation (piTBS) and repetitive transcranial magnetic stimulation (rTMS) are effective antidepressant interventions for major depressive disorder (MDD). Cognition-modulated frontal theta (frontalθ) activity had been identified to predict the antidepressant response to 10-Hz left prefrontal rTMS. However, whether this marker also predicts that of piTBS needs further investigation. Methods The present double-blind randomized trial recruited 105 patients with MDD who showed no response to at least one adequate antidepressant treatment in the current episode. The recruited patients were randomly assigned to one of three groups: group A received piTBS monotherapy; group B received rTMS monotherapy; and group C received sham stimulation. Before a 2-week acute treatment period, electroencephalopgraphy (EEG) and cognition-modulated frontal theta changes (Δfrontalθ) were measured. Depression scores were evaluated at baseline, 1 week, and 2 weeks after the initiation of treatment. Results The Δfrontalθ at baseline was significantly correlated with depression score changes at week 1 (r = −0.383, p = 0.025) and at week 2 for rTMS group (r = −0.419, p = 0.014), but not for the piTBS and sham groups. The area under the receiver operating characteristic curve for Δfrontalθ was 0.800 for the rTMS group (p = 0.003) and was 0.549 for the piTBS group (p = 0.619). Conclusion The predictive value of higher baseline Δfrontalθ for antidepressant efficacy for rTMS not only replicates previous results but also implies that the antidepressant responses to rTMS could be predicted reliably at baseline and both piTBS and rTMS could be effective through different neurobiological mechanisms.


2015 ◽  
Vol 113 (3) ◽  
pp. 822-833 ◽  
Author(s):  
Daisuke Sato ◽  
Koya Yamashiro ◽  
Hideaki Onishi ◽  
Baba Yasuhiro ◽  
Yoshimitsu Shimoyama ◽  
...  

Previous studies examining the influence of afferent stimulation on corticospinal excitability have demonstrated that the intensity of afferent stimulation and the nature of the afferents targeted (cutaneous/proprioceptive) determine the effects. In this study, we assessed the effects of whole-hand water immersion (WI) and water flow stimulation (WF) on corticospinal excitability and intracortical circuits by measuring motor evoked potential (MEP) recruitment curves and conditioned MEP amplitudes. We further investigated whether whole-hand WF modulated movement-related cortical activity. Ten healthy subjects participated in three experiments, comprising the immersion of participants' right hands with (whole-hand WF) or without (whole-hand WI) water flow, and no immersion (control). We evaluated MEP recruitment curves produced by a single transcranial magnetic stimulation (TMS) pulse at increasing stimulus intensities, short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF) using the paired TMS technique before and after 15 min of intervention. Movement-related cortical potentials (MRCPs) were evaluated to examine primary motor cortex, supplementary motor area, and somatosensory cortex excitability upon movement before and after whole-hand WF. After whole-hand WF, the slope of the MEP recruitment curve significantly increased, whereas SICI decreased and ICF increased in the contralateral motor cortex. The amplitude of the Bereitschaftspotential, negative slope, and motor potential of MRCPs significantly increased after whole-hand WF. We demonstrated that whole-hand WF increased corticospinal excitability, decreased SICI, and increased ICF, although whole-hand WI did not change corticospinal excitability and intracortical circuits. Whole-hand WF modulated movement-related cortical activity, increasing motor cortex activation for the planning and execution of voluntary movements.


Medicine ◽  
2020 ◽  
Vol 99 (32) ◽  
pp. e21493
Author(s):  
Lilei Dai ◽  
Peng Wang ◽  
Panpan Zhang ◽  
Qingshan Guo ◽  
Hui Du ◽  
...  

2019 ◽  
Vol 45 (4) ◽  
pp. 694-702 ◽  
Author(s):  
Nicholas L. Balderston ◽  
Emily M. Beydler ◽  
Camille Roberts ◽  
Zhi-De Deng ◽  
Thomas Radman ◽  
...  

AbstractMuch of the mechanistic research on anxiety focuses on subcortical structures such as the amygdala; however, less is known about the distributed cortical circuit that also contributes to anxiety expression. One way to learn about this circuit is to probe candidate regions using transcranial magnetic stimulation (TMS). In this study, we tested the involvement of the dorsolateral prefrontal cortex (dlPFC), in anxiety expression using 10 Hz repetitive TMS (rTMS). In a within-subject, crossover experiment, the study measured anxiety in healthy subjects before and after a session of 10 Hz rTMS to the right dorsolateral prefrontal cortex (dlPFC). It used threat of predictable and unpredictable shock to induce anxiety and anxiety potentiated startle to assess anxiety. Counter to our hypotheses, results showed an increase in anxiety-potentiated startle following active but not sham rTMS. These results suggest a mechanistic link between right dlPFC activity and physiological anxiety expression. This result supports current models of prefrontal asymmetry in affect, and lays the groundwork for further exploration into the cortical mechanisms mediating anxiety, which may lead to novel anxiety treatments.


2020 ◽  
Vol 32 (3) ◽  
pp. 128-134 ◽  
Author(s):  
Masachika Niimi ◽  
Yuko Fujita ◽  
Tamaki Ishima ◽  
Kenji Hashimoto ◽  
Nobuyuki Sasaki ◽  
...  

AbstractObjective:Abnormalities in neurotransmission via N-methyl-d-aspartic acid receptor (NMDAR) play a role in the pathophysiology of neuropsychiatric disorders. The impact of repetitive transcranial magnetic stimulation (rTMS) on NMDAR-related amino acids remains unknown. We aim to investigate the effects of rTMS on NMDAR-related amino acids in serum of post-stroke patients.Methods:Ninety-five consecutive post-stroke patients with upper limb hemiparesis were recruited. In 27 patients, the Beck Depression Inventory (BDI) score was 10 or higher. Twelve depressed patients underwent rehabilitation in combination with rTMS and 15 non-depressed patients underwent rehabilitation only without rTMS for 14 days. 1 Hz rTMS was applied to the primary motor area in the non-lesional hemisphere. BDI was conducted before and after treatment. Serum glutamine, glutamate, glycine, l-serine, and d-serine levels were measured before and after treatment.Results:There were no differences between depressed patients and non-depressed patients in clinical characteristics, levels of the five amino acids in serum, and the ratio of amino acids. However, in 27 depressed patients, there was a significant correlation between levels of glutamate in serum and BDI (ρ = 0.428, p = 0.026). BDI decreased significantly in depressed patients after treatment with or without rTMS. d-serine decreased in the rehabilitation with rTMS group, but increased in the rehabilitation without rTMS group. l-serine increased in the rehabilitation with rTMS group, but decreased in the rehabilitation without rTMS group.Conclusion:The results suggest that rTMS can modulate NMDAR-related amino acids in blood, producing beneficial effects.


2009 ◽  
Vol 106 (5) ◽  
pp. 1593-1603 ◽  
Author(s):  
Gabrielle Todd ◽  
Nigel C. Rogasch ◽  
Stanley C. Flavel ◽  
Michael C. Ridding

Repetitive transcranial magnetic stimulation (rTMS) can induce short-term reorganization of human motor cortex. Here, we investigated the effect of rTMS during relaxation and weak voluntary muscle contraction on motor cortex excitability and hand function. Subjects ( n = 60) participated in one of four studies. Single transcranial magnetic stimuli were delivered over the motor area of the first dorsal interosseus for measurement of motor evoked potential (MEP) size before and after real or sham rTMS delivered at an intensity of 80% of active motor threshold. rTMS involved trains of stimuli applied at 6 Hz for 5 s and repeated every 30 s for 10 min. Resting MEP size was suppressed for 15 min after rTMS during relaxation. However, MEP suppression was abolished when additional brief voluntary contractions were performed before and after rTMS ( study 1). Resting MEP size was suppressed for 30 min after rTMS during weak voluntary contraction. MEP suppression was present even though voluntary contractions were performed before and after rTMS ( study 2). The MEP suppression most likely reflects a decrease in motor cortical excitability. Surprisingly, rTMS during voluntary contraction did not alter maximal finger tapping speed or performance on a grooved pegboard test, object grip and lift task ( study 3), and visuomotor tracking task ( study 4). These studies document the complex relationship between voluntary movement and rTMS-induced plasticity in motor cortex. This work has implications for the optimization of rTMS parameters for improved efficacy and potential therapeutic applications.


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