O-14 Does rTMS targeting with individual functional connectivity analysis improve the efficacy in recurrent depression?

Abstract

Background Clinical efficacy of rTMS in recurrent depression (RD) is highly variable. It is important to search for approaches improving the efficacy, and choosing the target based on functional connectivity (FC) is promising. We aimed to compare the effects of the standard and FC-based rTMS targeting in RD patients. Methods 30 pharmacoresistant RD patients (17 women, age median 40, quartiles 28, 44) were divided into two groups comparable in age, sex and RD severity. All patients received 20 sessions of high frequency rTMS of lDLPFC (20 Hz, 100% RMT, 3200 stimuli/session). In the standard targeting group, the stimulation points were 5 cm anterior to the individual APB muscle hotspots. In the FC-based targeting group, rTMS was targeted to the individual points in the left DLPFC with maximum negative correlation to subgenual cingulate (10 mm radius sphere at MNI coordinates (6,16,−10)). We used Beck depression inventory (BDI) and SF-36 questionnaires before rTMS, after 10 and 20 sessions of rTMS for clinical evaluation. Results In the FC-based targeting group, significant decreases in both BDI and SF-36 scores were observed after 10 rTMS sessions (Wilcoxon, p 0.05). Conclusions Both methods of rTMS targeting are effective in depression, but the use of FC analysis allows accelerating the onset of the effect.