Abstract
The efficacy of rTMS, targeted at the Dorsolateral-Prefrontal-Cortex (DLPFC), to treat depression, has been well established. Currently, the clinical benefit of rTMS in depression is hypothesized to be mediated through the DLPFC-sgACC network, however to date there is no validated method that allows individualization of rTMS stimulation sites through target engagement. Previous studies demonstrated that stimulation of the DLPFC results in heart rate decelerations, indicating DLPFC-sgACC-vagus nerve connectivity. This suggests heart rate might serve as functional outcome measure of target engagement, which we validated in a recent pilot-study (Iseger et al., 2017). F3 and F4 stimulation resulted in the largest heart rate deceleration, in line with studies suggesting these are optimal 10-20 sites to target the DLPFC, however substantial individual variation was observed as well, suggesting possibilities for individualization.
Published Version
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