Individual interregional perfusion between the left dorsolateral prefrontal cortex stimulation targets and the subgenual anterior cortex predicts response and remission to aiTBS treatment in medication-resistant depression: The influence of behavioral inhibition

Wu, Guo-Rong; Baeken, Chris

doi:10.1016/j.brs.2021.12.003

Cited by 14 publications

(6 citation statements)

References 43 publications

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“…In support of this contention, Siddiqi et al [6] also found that stimulating the left DLPFC more anteriorly and laterally (with conventional daily rTMS) reduced sadness and melancholic symptoms, whereas stimulating the DLPFC more dorsally was more likely to affect 'anxiosomatic' symptoms. We have recently found evidence supporting the latter assumption with our aiTBS treatment protocol [7]. To some extent, this may also explain why correlations with clinical improvement were observed with the BDI-II and not the HDRS, since the BDI-II focuses more on the 'cognitive symptoms' of the depressed state [8].…”

Section: Dear Editor-in-chief Of Brain Stimulationmentioning

confidence: 65%

The left ventrolateral prefrontal cortex as a more optimal target for accelerated rTMS treatment protocols for depression?

Wu¹,

Baeken²

2023

Brain Stimulation

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Section: Dear Editor-in-chief Of Brain Stimulationmentioning

confidence: 65%

The left ventrolateral prefrontal cortex as a more optimal target for accelerated rTMS treatment protocols for depression?

Wu¹,

Baeken²

2023

Brain Stimulation

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“…89 Finally, a retrospective analysis found that individual baseline interregional perfusion and connectivity patterns could play a role in predicting antidepressant response to aiTBS. 107 Together, these brain imaging findings indicate that interregional connectivity and brain perfusion changes can be seen in depressed patients who respond to aiTBS therapy (or once daily iTBS and rTMS). Although larger, prospective validation is warranted, these findings were in keeping with earlier observations that functional connectivity between the prefrontal rTMS stimulation site and the sgACC correlated with and therefore had the potential to predict clinical response to rTMS/TBS therapy.…”

Section: Neuroimaging Findings In Accelerated Theta-burst Stimulation...mentioning

confidence: 84%

“…Additionally, the strengthening of functional connectivity between the sgACC and the ventromedial prefrontal cortex (VMPFC) was found to correlate with reductions in feelings of hopelessness 89 . Finally, a retrospective analysis found that individual baseline interregional perfusion and connectivity patterns could play a role in predicting antidepressant response to aiTBS 107 . Together, these brain imaging findings indicate that interregional connectivity and brain perfusion changes can be seen in depressed patients who respond to aiTBS therapy (or once daily iTBS and rTMS).…”

Section: The Pastmentioning

confidence: 97%

Accelerated Repetitive Transcranial Magnetic Stimulation to Treat Major Depression: The Past, Present, and Future

Chen

Klooster

Tik

et al. 2023

Harv Rev Psychiatry

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Repetitive transcranial magnetic stimulation (rTMS) is an effective and evidence-based therapy for treatment-resistant major depressive disorder. A conventional course of rTMS applies 20-30 daily sessions over 4-6 weeks. The schedule of rTMS delivery can be accelerated by applying multiple stimulation sessions per day, which reduces the duration of a treatment course with a predefined number of sessions. Accelerated rTMS reduces time demands, improves clinical efficiency, and potentially induces faster onset of antidepressant effects. However, considerable heterogeneity exists across study designs. Stimulation protocols vary in parameters such as the stimulation target, frequency, intensity, number of pulses applied per session or over a course of treatment, and duration of intersession intervals. In this article, clinician-researchers and neuroscientists who have extensive research experience in accelerated rTMS synthesize a consensus based on two decades of investigation and development, from early studies ("Past") to contemporaneous theta burst stimulation, a time-efficient form of rTMS gaining acceptance in clinical settings ("Present"). We propose descriptive nomenclature for accelerated rTMS, recommend avenues to optimize therapeutic and efficiency potential, and suggest using neuroimaging and electrophysiological biomarkers to individualize treatment protocols ("Future"). Overall, empirical studies show that accelerated rTMS protocols are well tolerated and not associated with serious adverse effects. Importantly, the antidepressant efficacy of accelerated rTMS appears comparable to conventional, once daily rTMS protocols. Whether accelerated rTMS induces antidepressant effects more quickly remains uncertain. On present evidence, treatment protocols incorporating high pulse dose and multiple treatments per day show promise and improved efficacy.

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“…This is presumably related to increasing evidence that the left DLPFC plays a direct role in depression symptoms, and may have both limited exploration of the parameter space for the anode position and restricted E-field values in this region. 59 - 61 …”

Section: Discussionmentioning

confidence: 99%

An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS)

Razza¹,

Wischnewski²,

Suen³

et al. 2023

Brazilian Journal of Psychiatry

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Objective: Transcranial direct current stimulation (tDCS) has mixed effects for major depressive disorder (MDD) symptoms, partially owing to large inter-experimental variability in tDCS protocols and their correlated induced electric fields (E-fields). We investigated whether the E-field strength of distinct tDCS parameters was associated with antidepressant effect. Methods: A meta-analysis was performed with placebo-controlled clinical trials of tDCS enrolling MDD patients. PubMed, EMBASE, and Web of Science were searched from inception to March 10, 2023. Effect sizes of tDCS protocols were correlated with E-field simulations (SimNIBS) of brain regions of interest (bilateral dorsolateral prefrontal cortex [DLPFC] and bilateral subgenual anterior cingulate cortex [sgACC]). Moderators of tDCS responses were also investigated. Results: A total of 20 studies were included (21 datasets, 1,008 patients), using 11 distinct tDCS protocols. Results revealed a moderate effect for MDD (g = 0.41, 95%CI 0.18-0.64), while cathode position and treatment strategy were found to be moderators of response. A negative association between effect size and tDCS-induced E-field magnitude was seen, with stronger E-fields in the right frontal and medial parts of the DLPFC (targeted by the cathode) leading to smaller effects. No association was found for the left DLPFC and the bilateral sgACC. An optimized tDCS protocol is proposed. Conclusions: Our results highlight the need for a standardized tDCS protocol in MDD clinical trials. Registration number: PROSPERO CRD42022296246.

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Individual interregional perfusion between the left dorsolateral prefrontal cortex stimulation targets and the subgenual anterior cortex predicts response and remission to aiTBS treatment in medication-resistant depression: The influence of behavioral inhibition

Cited by 14 publications

References 43 publications

The left ventrolateral prefrontal cortex as a more optimal target for accelerated rTMS treatment protocols for depression?

The left ventrolateral prefrontal cortex as a more optimal target for accelerated rTMS treatment protocols for depression?

Accelerated Repetitive Transcranial Magnetic Stimulation to Treat Major Depression: The Past, Present, and Future

An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS)

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