Modulation of the prefrontal blood oxygenation response to intermittent theta-burst stimulation in depression: A sham-controlled study with functional near-infrared spectroscopy

Struckmann, Wiebke; Persson, Jonas; Weigl, Wojciech; Gingnell, Malin; Bodén, Robert

doi:10.1080/15622975.2020.1785007

Cited by 10 publications

(12 citation statements)

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“…The change in depressive symptoms did not differ significantly between the treatment groups (U = 1.38, p = 0.175). These MADRS-S change scores have been reported elsewhere [14].…”

Section: Resultssupporting

confidence: 77%

“…In our study we used change in MADRS-S rating to control for treatment response. As has been reported in Struckmann et al (2020), there was a nonsignificant antidepressive effect on the group level [14]. In our data, we found no significant time x symptom change interaction, indicating that the decreasing pain over time could not be explained by the antidepressant effect of the treatment.…”

Section: Comparison With Previous Studies and Literature Decreasing Psupporting

confidence: 76%

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Pain trajectories of dorsomedial prefrontal intermittent theta burst stimulation versus sham treatment in depression

et al. 2020

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Background: Prefrontal repetitive transcranial magnetic stimulation is an established add-on treatment for major depressive disorder and is increasingly feasible with protocols of short duration, such as intermittent theta burst stimulation (iTBS). The most common and limiting side effect is pain at the site of application. Our objective was to investigate how pain develops over time in patients with depression receiving iTBS compared to sham stimulation. Methods: This is a subsample from a randomized clinical trial. Patients received daily sessions of 2400 pulses of dorsomedial prefrontal iTBS or sham stimulation with transcutaneous electric stimulation during 2 to 3 weeks. After unmasking of treatment allocation, patients receiving sham treatment were offered active iTBS in an open phase. Patients rated pain on a scale from 0 to 10 after the last train of stimulation on the first, fifth and final treatment day. A Mann-Whitney U-test was conducted to test for group differences and related-samples Friedman's tests to analyze changes in pain ratings over time. Results: The scalp pain in the group receiving iTBS was rated higher than sham treatment on the first (U = 263.5, p = 0.035) and fifth day (U = 271.0, p = 0.020) but not on the final day (U = 210.5, p = 0.121). The pain decreased mainly during the first 5 days of treatment (χ 2 = 0.875, p = 0.040). In the open phase the pain decreased from the first day to the final day (χ 2 = 1.194, p = 0.001). Conclusions: The subjective pain perception of active dorsomedial iTBS was higher than sham treatment but decreased over time, indicating an analgesic effect, or habituation. The result from this study can be used to inform patients about what to expect regarding pain during an iTBS treatment course. Trial registration: Clinicaltrials.gov, NCT02905604. Registered 19 September 2016.

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“…The change in depressive symptoms did not differ significantly between the treatment groups (U = 1.38, p = 0.175). These MADRS-S change scores have been reported elsewhere [14].…”

Section: Resultssupporting

confidence: 77%

Section: Comparison With Previous Studies and Literature Decreasing Psupporting

confidence: 76%

Pain trajectories of dorsomedial prefrontal intermittent theta burst stimulation versus sham treatment in depression

et al. 2020

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“…Also, Cao et al ( 59 ) investigated the effect of 5s trains of 1, 2, and 5 Hz stimulation delivered at the left DLPFC on twelve healthy participants, showing a decrease in blood oxygenation after 1 Hz compared to the [oxy-Hb] increases observed in both the 2 and 5 Hz stimulations. Although several NIRS studies ( 60 , 61 ) have also investigated the effects of rTMS on the MDD patients and described a modulation of the blood oxygenation response over the PFC that was built up during the course of rTMS treatment in depression, these studies measured the oxy-Hb response during TMS, not during a cognitive task. Given the interest in using rTMS to influence high-level cognitive function, the changes in functional measures during task-related activity are particularly important.…”

Section: Discussionmentioning

confidence: 99%

Increased Prefrontal Activation During Verbal Fluency Task After Repetitive Transcranial Magnetic Stimulation Treatment in Depression: A Functional Near-Infrared Spectroscopy Study

Huang

Zhang

et al. 2022

Front. Psychiatry

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BackgroundPrevious studies have shown the clinical effect of 2 Hz repetitive transcranial magnetic stimulation (rTMS) for depression; however, its underlying neural mechanisms are poorly understood. The aim of this study was to examine the effects of rTMS on the activity of the prefrontal cortex in patients with depression, using functional near-infrared spectroscopy (fNIRS).MethodsForty patients with major depressive disorder (MDD) and 40 healthy controls were enrolled in this study. Patients underwent 4 weeks of 2 Hz TMS delivered to the right dorsolateral prefrontal cortex (DLPFC). fNIRS was used to measure the changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex during a verbal fluency task (VFT) in depressed patients before and after rTMS treatment. The severity of depression was assessed using the Hamilton Rating Scale for Depression-24 item (HAMD-24).ResultsPrior to rTMS, depressed patients exhibited significantly smaller [oxy-Hb] values in the bilateral prefrontal cortex during the VFT compared with the healthy controls. After 4 weeks of 2 Hz right DLPFC rTMS treatment, increased [oxy-Hb] values in the bilateral frontopolar prefrontal cortex (FPPFC), ventrolateral prefrontal cortex (VLPFC) and left DLPFC during the VFT were observed in depressed patients. The increased [oxy-Hb] values from baseline to post-treatment in the right VLPFC in depressed patients were positively related to the reduction of HAMD score following rTMS.ConclusionThese findings suggest that the function of the prefrontal cortex in depressed patients was impaired and could be recovered by 2 Hz rTMS. The fNIRS-measured prefrontal activation during a cognitive task is a potential biomarker for monitoring depressed patients’ treatment response to rTMS.

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“…The rTMS procedure has been described in detail elsewhere ( 19 , 33 ). In short, the iTBS treatment was performed using the Cool D-B80 A/P butterfly coil (MagVenture, Denmark), designed for sham-controlled stimulation with one of the two identically looking coil sides being internally shielded to prevent the magnetic field from spreading.…”

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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Modulation of the prefrontal blood oxygenation response to intermittent theta-burst stimulation in depression: A sham-controlled study with functional near-infrared spectroscopy

Cited by 10 publications

References 44 publications

Pain trajectories of dorsomedial prefrontal intermittent theta burst stimulation versus sham treatment in depression

Pain trajectories of dorsomedial prefrontal intermittent theta burst stimulation versus sham treatment in depression

Increased Prefrontal Activation During Verbal Fluency Task After Repetitive Transcranial Magnetic Stimulation Treatment in Depression: A Functional Near-Infrared Spectroscopy Study

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

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