Abstract
Objectives: Repeated transcranial magnetic stimulation (rTMS) therapy has been applied in depressive disorders, but its neurobiological effect has not been well understood. Changes in cortical source network after treatment need to be confirmed. The present study investigated the effect of 3-week rTMS therapy on the symptom severity and cortical source network in patients with unipolar depression.Methods: Thirty-five patients with unipolar major depressive disorder participated in the study. High-frequency (10 Hz) rTMS was applied at the left dorsolateral prefrontal cortex during 3 weeks (five consecutive weekdays every week). Clinical symptoms were examined using the Hamilton Rating Scale for Depression and Anxiety. The resting state electroencephalography was recorded with 62 scalp channels before and after rTMS treatment.Results: Clinical symptoms significantly improved after rTMS treatment in both the active (p = 0.001) and sham groups (p = 0.002). However, an increased cortical source network in global and nodal levels was observed only in the active group after a 3-week treatment.Conclusions: The present study indicates that rTMS treatment leads to improved symptoms in patients with unipolar depression. Furthermore, treatment outcome of real effect was assured in changes of cortical source network.
Highlights
Repeated transcranial magnetic stimulation has been proposed as an alternative treatment for depression [1, 2], and it has been applied in other neuropsychiatric disorders [3,4,5]
We investigated the effect of Repeated transcranial magnetic stimulation (rTMS) treatment on the cortical source network in patients with unipolar depression using EEG based on the graph theory
The present study investigated the effects of 3-week rTMS treatment on the cortical source network in patients with unipolar depression
Summary
Repeated transcranial magnetic stimulation (rTMS) has been proposed as an alternative treatment for depression [1, 2], and it has been applied in other neuropsychiatric disorders [3,4,5]. Long-lasting effects on depression have been observed after applying high-frequency (10 to 20 Hz) rTMS at the dorsolateral prefrontal cortex (DLPFC) with multiple sessions in 10 to 15 consecutive days [7]. One previous study has demonstrated that rTMS therapy increases the connectivity of default mode regions, such as subgenual anterior cingulate cortex (sgACC), in depressive patients with traumatic brain injury [10]. High-frequency stimulation applied over the left prefrontal cortex induces an enhanced theta–gamma coupling [11] and modulates the resting state functional connectivity between the DLPFC and the limbic lobe [12]. Accelerated high-frequency rTMS improves functional connectivity in the sgACC region in patients with treatment-resistant unipolar depression [13]. The treatment effect of rTMS in patients with unipolar depression remains unclear how the clinically configured magnetic stimulation affects the cortical source region
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