Background

Repetitive Transcranial Magnetic Stimulation (rTMS) is an effective treatment for Major Depressive Disorder (MDD), but therapeutic benefit is highly variable. Clinical improvement is related to changes in brain circuits, which have preferred resonant frequencies (RFs) and vary across individuals.

Objective

We developed a novel rTMS-electroencephalography (rTMS-EEG) interrogation paradigm to identify RFs using the association of power/connectivity measures with symptom severity and treatment outcome.

Methods

35 subjects underwent rTMS interrogation at 71 frequencies ranging from 3 to 17 Hz administered to left dorsolateral prefrontal cortex (DLPFC). TMS-EEG was used to assess resonance in oscillatory power/connectivity changes (phase coherence [PC], envelope correlation [EC], and spectral correlation coefficient [SCC] after each frequency. Multiple regression was used to detect relationships between 10 Hz resonance and baseline symptoms as well as clinical improvement after 10 sessions of 10 Hz rTMS treatment.

Results

Baseline symptom severity was significantly associated with SCC resonance in left sensorimotor (SM; p < 0.0004), PC resonance in fronto-parietal (p = 0.001), and EC resonance in centro-posterior channels (p = 0.002). Subjects significantly improved with 10 sessions of rTMS treatment. Only decreased SCC SM resonance was significantly associated with clinical improvement (r = 0.35, p = 0.04). Subjects for whom 10 Hz SM SCC was highly ranked as an RF among all stimulation frequencies had better outcomes from 10 Hz treatment.

Conclusions

Resonance of 10 Hz stimulation measured using SCC correlated with both symptom severity and improvement with 10 Hz rTMS treatment. Research should determine whether this interrogation paradigm can identify individualized rTMS treatment frequencies.

中文翻译：

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使用重复经颅磁刺激 (rTMS) 识别个性化共振频率以治疗重度抑郁症 (MDD) 的新方法：概念验证研究

背景

重复经颅磁刺激 (rTMS) 是治疗重度抑郁症 (MDD) 的有效方法，但治疗效果差异很大。临床改善与大脑回路的变化有关，这些回路具有首选的共振频率 (RF) 并且因人而异。

客观的

我们开发了一种新的 rTMS-脑电图 (rTMS-EEG) 询问范式，以使用功率/连通性测量与症状严重程度和治疗结果的关联来识别 RF。

方法

35 名受试者接受了 71 种频率的 rTMS 讯问，频率范围从 3 到 17 Hz，施用于左背外侧前额叶皮层 (DLPFC)。TMS-EEG 用于评估振荡功率/连通性变化中的共振（相位相干 [PC]、包络相关 [EC] 和每个频率后的频谱相关系数 [SCC]。多元回归用于检测 10 Hz 共振和10 次 10 Hz rTMS 治疗后的基线症状和临床改善。

结果

基线症状严重程度与左感觉运动的 SCC 共振（SM；p < 0.0004）、额顶叶的 PC 共振（p = 0.001）和中央后通道的 EC 共振（p = 0.002）显着相关。受试者在 10 次 rTMS 治疗后显着改善。只有降低的 SCC SM 共振与临床改善显着相关（r = 0.35，p = 0.04）。10 Hz SM SCC 在所有刺激频率中被高度列为 RF 的受试者从 10 Hz 治疗中获得更好的结果。

结论

使用 SCC 测量的 10 Hz 刺激共振与症状严重程度和 10 Hz rTMS 治疗的改善相关。研究应确定这种审讯范式是否可以识别个性化的 rTMS 治疗频率。