Altered brain spontaneous activity by repetitive transcranial magnetic stimulation treatment for major depressive disorder
10.3760/cma.j.cn113661-20220704-00178
- VernacularTitle:重复经颅磁刺激治疗对抑郁症患者脑自发活动的影响
- Author:
Muzhen GUAN
1
;
Zhongheng WANG
;
Wenjun WU
;
Zhujing MA
;
Zirong LIU
;
Qingrong TAN
;
Huaihai WANG
;
Huaning WANG
Author Information
1. 空军军医大学第一附属医院心身科，西安 710032
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Amplitude of the low-frequency fluctuation;
Regional homogeneity;
Repetitive transcranial magnetic stimulation
- From:
Chinese Journal of Psychiatry
2022;55(5):383-392
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study explored the impacts of repetitive transcranial magnetic stimulation (rTMS) on spontaneous brain activity in patients with major depressive disorder (MDD).Methods:This study was a randomized controlled study. First-episode, drug-na?ve patients with MDD ( n=27) and healthy controls ( n=30) were enrolled. The left dorsolateral prefrontal region was the stimulation target, and all participants received rTMS treatment for fifteen successive days. Hamilton Depression Rating Scale (HAMD 17) and resting-state functional magnetic resonance imaging (rs-fMRI) data were collected at baseline and the 15th day of the treatment. Changes in the spontaneous brain activity before and after the treatment were compared using the paired samples t-test or the independent sample t-test. The two indices of the amplitude of the low-frequency fluctuation (ALFF) and regional homogeneity(ReHo) were applied to reflect the spontaneous brain activity. Results:After treatment, the score of HAMD 17 (9.4±4.3) in MDD patients was significantly lower than that before the treatment (21.1±6.0), the average score decreased by (11.7±3.6), the remission rate was 40.74%, and the response rate was 74.07%. fMRI results: Before treatment, patients with MDD had significantly lower ALFF in the left superior frontal gyrus ( t=-8.14, P<0.001), higher ALFF in the left middle frontal gyrus and left precuneus ( t=5.79, 6.24, P<0.001), and lower ReHo in the left middle frontal and left middle occipital gyri ( t=-5.17, -6.11, P<0.001) than the corresponding values observed in healthy controls; After the rTMS treatment, the ALFF significantly increased in the left superior frontal gyrus ( t=7.32, P<0.001) and decreased in the left middle frontal gyrus and left precuneus ( t=-4.96,-5.14, P<0.001). Furthermore, ReHo significantly increased in the left middle frontal and left middle occipital gyri ( t=4.25,4.19, P<0.001) in patients with MDD. The score of HAMD 17 after treatment was significantly and negatively correlated with ALFF value of left superior frontal gyrus after treatment ( r=-0.390, P=0.044). Conclusion:Successive 15-day rTMS treatment could efficiently and effectively alleviate individual′s depressive symptoms. The left middle frontal gyrus may play an important role in abnormal spontaneous brain activity in MDD patients; and left superior frontal gyrus function may be essential in improving depressive symptoms.
