Intermittent theta burst stimulation over the dorsomedial prefrontal cortex modulates resting-state connectivity in depressive patients: A sham-controlled study

Persson, Jonas; Struckmann, Wiebke; Gingnell, Malin; Fällmar, David; Bodén, Robert

doi:10.1016/j.bbr.2020.112834

Cited by 24 publications

(20 citation statements)

References 38 publications

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“…Similarly, an iTBS study reported an increase in connectivity between the target area (dorsomedial PFC) and regions from the default mode network and the salience network. This increase in connectivity was predictive of symptom improvement ( Persson et al, 2020 ).…”

Section: Functional Magnetic Resonance Imaging Evaluations Of Repetit...mentioning

confidence: 99%

Insight Into the Effects of Clinical Repetitive Transcranial Magnetic Stimulation on the Brain From Positron Emission Tomography and Magnetic Resonance Imaging Studies: A Narrative Review

2022

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Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a therapeutic tool to alleviate symptoms for neurological and psychiatric diseases such as chronic pain, stroke, Parkinson’s disease, major depressive disorder, and others. Although the therapeutic potential of rTMS has been widely explored, the neurological basis of its effects is still not fully understood. Fortunately, the continuous development of imaging techniques has advanced our understanding of rTMS neurobiological underpinnings on the healthy and diseased brain. The objective of the current work is to summarize relevant findings from positron emission tomography (PET) and magnetic resonance imaging (MRI) techniques evaluating rTMS effects. We included studies that investigated the modulation of neurotransmission (evaluated with PET and magnetic resonance spectroscopy), brain activity (evaluated with PET), resting-state connectivity (evaluated with resting-state functional MRI), and microstructure (diffusion tensor imaging). Overall, results from imaging studies suggest that the effects of rTMS are complex and involve multiple neurotransmission systems, regions, and networks. The effects of stimulation seem to not only be dependent in the frequency used, but also in the participants characteristics such as disease progression. In patient populations, pre-stimulation evaluation was reported to predict responsiveness to stimulation, while post-stimulation neuroimaging measurements showed to be correlated with symptomatic improvement. These studies demonstrate the complexity of rTMS effects and highlight the relevance of imaging techniques.

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Section: Functional Magnetic Resonance Imaging Evaluations Of Repetit...mentioning

confidence: 99%

Insight Into the Effects of Clinical Repetitive Transcranial Magnetic Stimulation on the Brain From Positron Emission Tomography and Magnetic Resonance Imaging Studies: A Narrative Review

2022

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“…Intermittent theta-burst stimulation (iTBS) is a newer form of rTMS with a much shorter application duration but comparable clinical effectiveness to the standard protocols ( Blumberger et al, 2018 ). In a recent sham-controlled study of iTBS over the dmPFC by our group, we found a symptom related FC increase between the treatment target and the precuneus ( Persson et al, 2020 ). Furthermore, baseline connectivity between this region and both treatment target and sgACC was predictive of treatment response, highlighting the role of the dmPFC as a crucial node between different brain networks affected in depression ( Sheline et al, 2010 ) and that its connectivity strength can be modulated by rTMS.…”

Section: Introductionmentioning

confidence: 63%

“…This project shares data with a recent randomized clinical trial comprising patients with depression or schizophrenia ( Bodén et al, 2021 ) and its add-on brain-imaging study ( Persson et al, 2020 ), with all patients being recruited from the psychiatric outpatient clinic at Uppsala University Hospital, Sweden. Out of 101 eligible patients from these two studies, 69 were finally randomized (not meeting the inclusion criteria: n = 5, declined to participate: n = 26, other reasons: n = 1).…”

Section: Methodsmentioning

confidence: 99%

Modulation of dorsolateral prefrontal cortex functional connectivity after intermittent theta-burst stimulation in depression: Combining findings from fNIRS and fMRI

Struckmann

Bodén

Gingnell

et al. 2022

NeuroImage: Clinical

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“…Both the cognitive test battery and the fNIRS acquisition took place at baseline 1 day before treatment start, and once again 4 weeks later. This time interval was chosen to test for potential delayed treatment effects and to synchronize with a neuroimaging study ( 32 ).…”

Section: Methodsmentioning

confidence: 99%

Unchanged Cognitive Performance and Concurrent Prefrontal Blood Oxygenation After Accelerated Intermittent Theta-Burst Stimulation in Depression: A Sham-Controlled Study

et al. 2021

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Aim: Intermittent theta-burst stimulation (iTBS) delivered over the dorsomedial prefrontal cortex (DMPFC) has shown promise as a treatment for anhedonia and amotivation in patients with depression. Here, we investigated whether this protocol modulates cognitive performance and concurrent prefrontal blood oxygenation. We also examined whether depressed patients exhibit cognitive dysfunction and prefrontal hypoactivity at baseline compared to healthy controls.Methods: This sham-controlled study comprises 52 patients randomized to either active or sham accelerated iTBS over the DMPFC (applied twice daily) for 10 consecutive treatment days, and 55 healthy controls. Cognitive performance was assessed at baseline and once again 4 weeks later using a cognitive test battery targeting attention, inhibitory control, and numerical, verbal, and visual working memory. Concurrent prefrontal oxygenated hemoglobin (oxy-Hb) was captured with functional near-infrared spectroscopy.Results: Active iTBS over DMPFC did not affect cognitive performance or concurrent oxy-Hb change compared to sham iTBS in patients with depression. Compared to controls, patients at baseline showed impaired performance in the Trail Making Test, the Rey Auditory Verbal Learning Test, the Animal Naming Test, and the Digit Symbol Substitution Test, however no difference in prefrontal oxy-Hb was observed.Conclusion: Patients with treatment-resistant depression displayed cognitive deficits, however without prefrontal hypoactivity, compared to healthy controls at baseline. iTBS treatment did not alter cognitive performance, nor concurrent prefrontal blood oxygenation, in patients. Taken together, iTBS can likely be considered a cognitively safe treatment option in this sample of patients.

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Intermittent theta burst stimulation over the dorsomedial prefrontal cortex modulates resting-state connectivity in depressive patients: A sham-controlled study

Cited by 24 publications

References 38 publications

Insight Into the Effects of Clinical Repetitive Transcranial Magnetic Stimulation on the Brain From Positron Emission Tomography and Magnetic Resonance Imaging Studies: A Narrative Review

Insight Into the Effects of Clinical Repetitive Transcranial Magnetic Stimulation on the Brain From Positron Emission Tomography and Magnetic Resonance Imaging Studies: A Narrative Review

Modulation of dorsolateral prefrontal cortex functional connectivity after intermittent theta-burst stimulation in depression: Combining findings from fNIRS and fMRI

Unchanged Cognitive Performance and Concurrent Prefrontal Blood Oxygenation After Accelerated Intermittent Theta-Burst Stimulation in Depression: A Sham-Controlled Study

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