Clinical and radiomic features for predicting the treatment response of repetitive transcranial magnetic stimulation in major neurocognitive disorder: Results from a randomized controlled trial

Abstract

Image-guided repetitive transcranial magnetic stimulation (rTMS) has shown clinical effectiveness in senior adults with co-occurring depression and cognitive impairment, yet the imaging markers for predicting the treatment response are less investigated. In this clinical trial, we examined the efficacy and sustainability of 10 Hz rTMS for the treatment of depression and cognitive impairment in major neurocognitive disorder (NCD) patients and tested the predictive values of imaging-informed radiomic features in response to rTMS treatment. Fifty-five major NCD patients with depression were randomly assigned to receive a 3-week rTMS treatment of either active 10 Hz rTMS (n = 27) or sham rTMS (n = 28). Left dorsolateral prefrontal cortex (DLPFC) was the predefined treatment target. Based on individual structural magnetic resonance imaging scans, surface-based analysis was conducted to quantitatively measure the baseline radiomic features of left DLPFC. Severity of depression, global cognition and the serum brain-derived neurotrophic factor (BDNF) level were evaluated at baseline, 3-, 6-and 12-week follow-ups. Logistic regression analysis revealed that advanced age, higher baseline cognition and randomized group were associated with the remission of depression. Increased cortical thickness and gyrification in left DLPFC were the significant predictors of clinical remission and cognitive enhancement. A 3-week course of 10 Hz rTMS is an effective adjuvant treatment for rapid ameliorating depressive symptoms and enhancing cognitive function. Pre-treatment radiomic features of the stimulation target can predict the response to rTMS treatment in major NCD. Cortical thickness and folding of treatment target may serve as

Brain-Derived Neurotrophic Factor (BDNF) as a Predictor of Treatment Response in Major Depressive Disorder (MDD): A Systematic Review

“…Likewise, another study from 2022 focused on measuring the effectiveness of repetitive transcranial magnetic stimulation (rTMS) presented results where the basal levels of BDNF do not show differences between the control group and MDD, related neither to the severity nor to the level of cognitive deficit. In this study, only a marginal increase in BDNF levels was presented [32].…”

MRI-informed machine learning-driven brain age models for classifying mild cognitive impairment converters

“…BrainSuite is an automatic brain surface identification integrated computational platform with the updated version of cortical surface extraction, which is suitable for adults with cortical atrophy. 28 , 29 To calculate the region-specific cortical features, we followed the standard pipeline with default settings. 30 Through uploading each subject’s structural MRI data to BrainSuite, the image processing methods include a series of steps: (1) head motion correction; (2) image intensity normalization; (3) removal of the non-brain voxels; (4) segmentation of gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF); (5) tessellation of GM/WM boundary, and topology correction.…”

Unlocking the Potential of Repetitive Transcranial Magnetic Stimulation in Alzheimer’s Disease: A Meta-Analysis of Randomized Clinical Trials to Optimize Intervention Strategies

“…The intensities in most studies were 90%, 100%, and 120% of the motor threshold. Among the various stimulation sites explored, the dorsolateral prefrontal cortex (DLPFC) emerged as a frequently targeted region across multiple studies [25,43,[51][52][53][54][55][56][57]. Additionally, other targets included the hippocampus [36,58], angular gyrus [59], precuneus [60], cerebellum [61], and regions adjacent to the temporal lobe [34,62].…”

“…Four studies included in the analysis reported results on emotional outcomes using scales such as the Geriatric Depression Scale, Patient Health Questionnaire-9, and Cornell Scale for Depression in Dementia [36,43,52]. The findings suggest that there was no statistically significant effect on emotion compared to sham stimulation (p = 0.78, SMD = 0.07, 95%CI = -0.40-0.53) (see Fig.…”