TY - JOUR
T1 - Effects of bilateral sequential theta-burst stimulation on functional connectivity in treatment-resistant depression
T2 - First results
AU - Stöhrmann, Peter
AU - Godbersen, Godber Mathis
AU - Reed, Murray Bruce
AU - Unterholzner, Jakob
AU - Klöbl, Manfred
AU - Baldinger-Melich, Pia
AU - Vanicek, Thomas
AU - Hahn, Andreas
AU - Lanzenberger, Rupert
AU - Kasper, Siegfried
AU - Kranz, Georg S.
N1 - Funding Information:
This research was funded in whole, or in part, by the Austrian Science Fund (FWF) [Grant number KLI 551 , PI: S. Kasper]. For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. M.B. Reed is a recipient of a DOC fellowship of the Austrian Academy of Sciences at the Department of Psychiatry and Psychotherapy, Medical University of Vienna. We would like to express our gratitude towards Robin Cash, Andrew Zalesky, Luca Cocchi and their colleagues for providing us with FC-maps derived from the Human Brain Project and valuable insights, as well as Jonathan Downar for his assistance in the conceptualization of the study. We would further like to thank Richard Frey, Gregor Gryglewski, Marius Hienert, Marie Spies, Christoph Kraus, Alexander Kautzky, Arkadiusz Komorowski, Paul Michenthaler for clinical support, and Sebastian Ganger for technical support, and all additional staff and students from the Neuroimaging Lab (NIL) involved in the realization of this research.
Funding Information:
This research was funded in whole, or in part, by the Austrian Science Fund (FWF) [Grant number KLI 551, PI: S. Kasper]. For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. M.B. Reed is a recipient of a DOC fellowship of the Austrian Academy of Sciences at the Department of Psychiatry and Psychotherapy, Medical University of Vienna. We would like to express our gratitude towards Robin Cash, Andrew Zalesky, Luca Cocchi and their colleagues for providing us with FC-maps derived from the Human Brain Project and valuable insights, as well as Jonathan Downar for his assistance in the conceptualization of the study. We would further like to thank Richard Frey, Gregor Gryglewski, Marius Hienert, Marie Spies, Christoph Kraus, Alexander Kautzky, Arkadiusz Komorowski, Paul Michenthaler for clinical support, and Sebastian Ganger for technical support, and all additional staff and students from the Neuroimaging Lab (NIL) involved in the realization of this research.
Publisher Copyright:
© 2023 The Authors
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background: Previous studies suggest that transcranial magnetic stimulation exerts antidepressant effects by altering functional connectivity (FC). However, knowledge about this mechanism is still limited. Here, we aimed to investigate the effect of bilateral sequential theta-burst stimulation (TBS) on FC in treatment-resistant depression (TRD) in a sham-controlled longitudinal study. Methods: TRD patients (n = 20) underwent a three-week treatment of intermittent TBS of the left and continuous TBS of the right dorsolateral prefrontal cortex (DLPFC). Upon this trial's premature termination, 15 patients had received active TBS and five patients sham stimulation. Resting-state functional magnetic resonance imaging was performed at baseline and after treatment. FC (left and right DLPFC) was estimated for each participant, followed by group statistics (t-tests). Furthermore, depression scores were analyzed (linear mixed models analysis) and tested for correlation with FC. Results: Both groups exhibited reductions of depression scores, however, there was no significant main effect of group, or group and time. Anticorrelations between DLPFC and the subgenual cingulate cortex (sgACC) were observed for baseline FC, corresponding to changes in depression severity. Treatment did not significantly change DLPFC-sgACC connectivity, but significantly reduced FC between the left stimulation target and bilateral anterior insula. Conclusions: Our data is compatible with previous reports on the relevance of anticorrelation between DLPFC and sgACC for treatment success. Furthermore, FC changes between left DLPFC and bilateral anterior insula highlight the effect of TBS on the salience network. Limitations: Due to the limited sample size, results should be interpreted with caution and are of exploratory nature.
AB - Background: Previous studies suggest that transcranial magnetic stimulation exerts antidepressant effects by altering functional connectivity (FC). However, knowledge about this mechanism is still limited. Here, we aimed to investigate the effect of bilateral sequential theta-burst stimulation (TBS) on FC in treatment-resistant depression (TRD) in a sham-controlled longitudinal study. Methods: TRD patients (n = 20) underwent a three-week treatment of intermittent TBS of the left and continuous TBS of the right dorsolateral prefrontal cortex (DLPFC). Upon this trial's premature termination, 15 patients had received active TBS and five patients sham stimulation. Resting-state functional magnetic resonance imaging was performed at baseline and after treatment. FC (left and right DLPFC) was estimated for each participant, followed by group statistics (t-tests). Furthermore, depression scores were analyzed (linear mixed models analysis) and tested for correlation with FC. Results: Both groups exhibited reductions of depression scores, however, there was no significant main effect of group, or group and time. Anticorrelations between DLPFC and the subgenual cingulate cortex (sgACC) were observed for baseline FC, corresponding to changes in depression severity. Treatment did not significantly change DLPFC-sgACC connectivity, but significantly reduced FC between the left stimulation target and bilateral anterior insula. Conclusions: Our data is compatible with previous reports on the relevance of anticorrelation between DLPFC and sgACC for treatment success. Furthermore, FC changes between left DLPFC and bilateral anterior insula highlight the effect of TBS on the salience network. Limitations: Due to the limited sample size, results should be interpreted with caution and are of exploratory nature.
KW - Depression
KW - Functional connectivity
KW - Magnetic resonance imaging
KW - Major depressive disorder
KW - Transcranial magnetic stimulation
UR - https://www.scopus.com/pages/publications/85146242678
U2 - 10.1016/j.jad.2022.12.088
DO - 10.1016/j.jad.2022.12.088
M3 - Journal article
C2 - 36603604
AN - SCOPUS:85146242678
SN - 0165-0327
VL - 324
SP - 660
EP - 669
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -
SDG 3 Good Health and Well-being