Analysis of Brain Functional Changes in High-Frequency Repetitive Transcranial Magnetic Stimulation in Treatment-Resistant Depression

Özekes, Serhat; Ergüzel, Türker Tekin; Sayar, Gökben Hızlı; Tarhan, Nevzat

doi:10.1177/1550059413515656

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…Cordance, which is related to absolute and relative spectral powers derived from the resting EEG, increased after HFL-rTMS in both delta and theta bands at left frontal and all right electrodes, except for the F8 electrode, in responders, whereas it decreased in left frontal and right prefrontal regions in non-responder (Ozekes et al 2014).…”

Section: Resultsmentioning

confidence: 99%

“…2005 a ) as well as prefrontal cordance increase in the theta band (Ozekes et al . 2014) following successful rTMS may reflect the improvement of the cortical GABA B receptor-mediated inhibitory functioning, and increased metabolic activity and blood flow perfusion in frontal regions, seen with rTMS of the DLPFC. More comprehensive studies that include multimodal biological markers are needed to better understand the antidepressant mechanism of DLPFC-rTMS treatment.…”

Section: Discussionmentioning

confidence: 99%

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Neurobiological mechanisms of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex in depression: a systematic review

et al. 2015

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Depression is one of the most prevalent mental illnesses worldwide and a leading cause of disability, especially in the setting of treatment resistance. In recent years, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising alternative strategy for treatment-resistant depression and its clinical efficacy has been investigated intensively across the world. However, the underlying neurobiological mechanisms of the antidepressant effect of rTMS are still not fully understood. This review aims to systematically synthesize the literature on the neurobiological mechanisms of treatment response to rTMS in patients with depression. Medline (1996-2014), Embase (1980-2014) and PsycINFO (1806-2014) were searched under set terms. Three authors reviewed each article and came to consensus on the inclusion and exclusion criteria. All eligible studies were reviewed, duplicates were removed, and data were extracted individually. Of 1647 articles identified, 66 studies met both inclusion and exclusion criteria. rTMS affects various biological factors that can be measured by current biological techniques. Although a number of studies have explored the neurobiological mechanisms of rTMS, a large variety of rTMS protocols and parameters limits the ability to synthesize these findings into a coherent understanding. However, a convergence of findings suggest that rTMS exerts its therapeutic effects by altering levels of various neurochemicals, electrophysiology as well as blood flow and activity in the brain in a frequency-dependent manner. More research is needed to delineate the neurobiological mechanisms of the antidepressant effect of rTMS. The incorporation of biological assessments into future rTMS clinical trials will help in this regard.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neurobiological mechanisms of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex in depression: a systematic review

et al. 2015

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“…36 In addition, a series of studies of subjects with MDD undergoing antidepressant treatment have examined changes in synchrony using qEEG power or cordance (a measure derived from power normalized across frequency bands and electrode sites). These studies have consistently shown that changes in theta and alpha power 35,39,40 or cordance with a range of antidepressant medications, [41][42][43][44][45][46][47] rTMS, [48][49][50] or DBS 51 are strongly predictive of clinical response or remission with active treatment. Regional changes in brain oscillatory synchrony appear to be relatively specific for response to medication and not placebo, 31,52 and to distinguish between the effects of medication and placebo on brain function in healthy control subjects.…”

Section: The Development Of Ips Based On Oscillatory Synchronymentioning

confidence: 95%

Intermediate phenotypes and biomarkers of treatment outcome in major depressive disorder

Leuchter

Hunter

Krantz

et al. 2014

Dialogues in Clinical Neuroscience

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Major depressive disorder (MDD) is a pleomorphic illness originating from gene x environment interactions. Patients with differing symptom phenotypes receive the same diagnosis and similar treatment recommendations without regard to genomics, brain structure or function, or other physiologic or psychosocial factors. Using this present approach, only one third of patients enter remission with the first medication prescribed, and patients may take longer than 1 year to enter remission with repeated trials. Research to improve treatment effectiveness recently has focused on identification of intermediate phenotypes (IPs) that could parse the heterogeneous population of patients with MDD into subgroups with more homogeneous responses to treatment. Such IPs could be used to develop biomarkers that could be applied clinically to match patients with the treatment that would be most likely to lead to remission. Putative biomarkers include genetic polymorphisms, RNA and protein expression (transcriptome and proteome), neurotransmitter levels (metabolome), additional measures of signaling cascades, oscillatory synchrony, neuronal circuits and neural pathways (connectome), along with other possible physiologic measures. All of these measures represent components of a continuum that extends from proximity to the genome to proximity to the clinical phenotype of depression, and there are many levels along this continuum at which useful IPs may be defined. Because of the highly integrative nature of brain systems and the complex neurobiology of depression, the most useful biomarkers are likely to be those with intermediate proximity both to the genome and the clinical phenotype of MDD. Translation of findings across the spectrum from genotype to phenotype promises to better characterize the complex disruptions in signaling and neuroplasticity that accompany MDD, and ultimately to lead to greater understanding of the causes of depressive illness.

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“…Furthermore, LORETA validation has been based on accepting as ground truth, the localization findings obtained from invasively implanted depth electrodes, as evident by several studies on epilepsy (66-68) and cognitive ERPs (69). Current density values were computed in eight frequency bands delta (0.5-3.5 Hz), theta (4-8 Hz), alpha-1 (8.5-10 Hz), alpha-2 (10.5-12 Hz), beta-1 (12.5-18 Hz), beta-2 (18.5-21 Hz), beta-3 (21.5-30 Hz), and gamma (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). These frequency bands were defined on the basis of factorial analysis of EEG records and are part of the guidelines and recommendations for the analysis of EEG records in the field of medical electrophysiological research (70).…”

Section: Eloreta Calculationmentioning

confidence: 99%

“…Several recent QEEG studies have partially demonstrated the ability to predict rTMS treatment response (14,31). Among the findings, a non-response or poorer response to treatment is characterized as: a change of power in theta (31)(32)(33), alpha (34), and beta (30) bands in the frontal cortex, prefrontal beta or theta cordance; decrease/unchanged between the baseline and first week of rTMS application (31,35,36); slowing of the anterior alpha peak or a decrease in its frequency (31); larger amplitude of evoked potential P300 (31); no increase in the Lempel-Ziv complex (from minute 1 to 2) in the alpha band (37); and a change in the beta phase-locking values (38).…”

Section: Introductionmentioning

confidence: 99%

Baseline Difference in Quantitative Electroencephalography Variables Between Responders and Non-Responders to Low-Frequency Repetitive Transcranial Magnetic Stimulation in Depression

et al. 2020

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Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depressive disorder, with outcomes approaching 45-55% response and 30-40% remission. Eligible predictors of treatment outcome, however, are still lacking. Few studies have investigated quantitative electroencephalography (QEEG) parameters as predictors of rTMS treatment outcome and none of them have addressed the source localization techniques to predict the response to low-frequency rTMS (LF rTMS). We investigated electrophysiological differences based on scalp EEG data and inverse solution method, exact low-resolution brain electromagnetic tomography (eLORETA), between responders and non-responders to LF rTMS in resting brain activity recorded prior to the treatment. Twenty-five unmedicated depressive patients (mean age of 45.7 years, 20 females) received a 4week treatment of LF rTMS (1 Hz; 20 sessions per 600 pulses; 100% of the motor threshold) over the right dorsolateral prefrontal cortex. Comparisons between responders (≥50% reduction in Montgomery-Åsberg Depression Rating Scale score) and nonresponders were made at baseline for measures of eLORETA current density, spectral absolute power, and inter-hemispheric and intra-hemispheric EEG asymmetry. Responders were found to have lower current source densities in the alpha-2 and beta-1 frequency bands bilaterally (with predominance on the left side) in the inferior, medial, and middle frontal gyrus, precentral gyrus, cingulate gyrus, anterior cingulate, and insula. The most pronounced difference was found in the left middle frontal gyrus for alpha-2 and beta-1 bands (p < 0.05). Using a spectral absolute power analysis, we found a negative correlation between the absolute power in beta and theta frequency bands on the left frontal electrode F7 and the change in depressive symptomatology. None of the selected asymmetries significantly differentiated responders from non-responders in any frequency band. Pre-treatment reduction of alpha-2 and beta-1 sources, but not QEEG asymmetry, was found in patients with major depressive disorder who responded to LF

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Analysis of Brain Functional Changes in High-Frequency Repetitive Transcranial Magnetic Stimulation in Treatment-Resistant Depression

Cited by 5 publications

References 28 publications

Neurobiological mechanisms of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex in depression: a systematic review

Neurobiological mechanisms of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex in depression: a systematic review

Intermediate phenotypes and biomarkers of treatment outcome in major depressive disorder

Baseline Difference in Quantitative Electroencephalography Variables Between Responders and Non-Responders to Low-Frequency Repetitive Transcranial Magnetic Stimulation in Depression

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