Whole brain TMS-evoked dose-response patterns of BOLD signal

Tik, Martin; Woletz, Michael; Vasileiadi, Maria; Linhardt, David; Schuler, Anna‐Lisa; Williams, Nolan; Windischberger, Christian

doi:10.1016/j.brs.2023.01.235

Cited by 1 publication

(1 citation statement)

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“…While correcting for baseline depression scores did not reveal any difference in symptom improvement between groups, there may have still been residual effects that affected the possible degree of improvement in the DLPFC/preSMA rTMS groups. Thirdly, subthreshold rTMS has been documented to have measurable physiological effects on the brain (32,33). There is a possibility that, despite the subthreshold stimulation intensity and the greater distance between the coil and the brain in the vertex condition, some stimulation of the parietal cortex occurred, contributing to a therapeutic effect.…”

Section: Discussionmentioning

confidence: 99%

TMS-induced plasticity improving cognitive control in OCD I: Clinical and neuroimaging outcomes from a randomised trial of rTMS for OCD

Fitzsimmons,

Postma,

van Campen

et al. 2023

Preprint

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BackgroundRepetitive transcranial magnetic stimulation (rTMS) is an emerging treatment option for obsessive-compulsive disorder (OCD). The neurobiological mechanisms of rTMS in OCD have, however, been incompletely characterized. We compared clinical outcomes and changes in task-based brain activation following three different rTMS stimulation protocols, all combined with exposure and response prevention (ERP).MethodsIn this three-arm proof-of-concept randomized controlled clinical trial, 61 treatment-refractory adult OCD patients received 16 sessions of rTMS immediately prior to ERP over 8 weeks, with task-based functional MRI (tb-fMRI) scans and clinical assessments pre- and post-treatment. Patients received either: high frequency (HF) rTMS to the left dorsolateral prefrontal cortex (DLPFC) (n=19 (6M/13F)); HF rTMS to the left pre-supplementary motor area (preSMA) (n=23 (10M/13F)); or control rTMS to the vertex (n=19 (6M/13F)). Changes in tb-fMRI activation pre-post treatment were compared using both a Bayesian region-of-interest and a general linear model whole-brain approach.ResultsMean OCD symptom severity decreased significantly in all treatment groups (delta=- 10.836, p<0.001, 95% CI [-12.504, -9.168]), with no differences between groups. Response rate in the entire sample was 57.4%. Groups receiving DLPFC or preSMA rTMS showed, respectively, a decrease in planning and error processing task-related activation after treatment that was associated with symptom improvement, while individuals in the vertex rTMS group with greater symptom improvement showed an increase in inhibition-related activation.ConclusionsPreSMA and DLPFC rTMS combined with ERP led to significant symptom improvement related to activation decreases in targeted task networks, although we observed no differences in symptom reduction between groups.This trial was registered at clinicaltrials.gov (NCT03667807)

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Section: Discussionmentioning

confidence: 99%