EA 4617 Fonctions Cérébrales et Neuromodulation, Grenoble Institut des Neurosciences, Université Joseph Fourier, Grenoble, France.
EA 4617 Fonctions Cérébrales et Neuromodulation, Grenoble Institut des Neurosciences, Université Joseph Fourier, Grenoble, France; Clinique Universitaire de Psychiatrie, Pôle Psychiatrie Neurologie, Centre Hospitalier Universitaire, Grenoble, France.
J Affect Disord. 2015 Sep 1;183:15-21. doi: 10.1016/j.jad.2015.04.029. Epub 2015 Apr 24.
Major depressive disorder (MDD) and bipolar disorder (BP) are two different types of mood disorders, sometimes difficult to distinguish from their depressive symptoms, and for which repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) has been proposed to treat refractory patients. Here we studied whether the electroencephalogram (EEG) at rest could be used to predict the therapeutic response to left DLPFC 10 Hz rTMS, and to which extent BP and MDD patients show similar correlation between the clinical response and the cortical networks at rest.
Eight MDD (6 females) and 10 BP patients (6 females) were included. The rTMS therapy consisted of 10 to 20 neuronavigated sessions, with 2000 pulses continuously applied at 120% motor threshold for each session. RTMS sessions at the beginning, middle and end of the therapy were performed while recording EEG signals. EEG spectral power was partitioned using the common physiological frequency bands and was statistically analysed at the scalp level and after cortical source reconstruction.
We found significantly higher power in theta and beta bands in BP patients than in MDD patients, mainly localised in the prefrontal cortex. In addition, responders showed higher power in delta and theta bands in parietal regions and weaker frontal alpha power, when compared to non-responders.
These preliminary findings on a small cohort suggest that pre-treatment EEG oscillatory patterns may have some predictive value regarding rTMS therapy, both for MDD and BP disorders.
重度抑郁症（MDD）和双相情感障碍（BP）是两种不同类型的心境障碍，有时难以从其抑郁症状中区分出来，对于这些患者，重复经颅磁刺激（rTMS）已被提议用于治疗难治性患者。在这里，我们研究了静息脑电图（EEG）是否可用于预测左侧背外侧前额叶皮层（DLPFC）10 Hz rTMS 的治疗反应，以及 BP 和 MDD 患者在临床反应与静息皮质网络之间表现出多大程度的相似相关性。
纳入 8 名 MDD（6 名女性）和 10 名 BP 患者（6 名女性）。rTMS 治疗包括 10-20 次神经导航治疗，每次治疗以 120%运动阈值连续应用 2000 个脉冲。在治疗的开始、中间和结束时进行 RTMS 治疗，并记录 EEG 信号。使用常见的生理频带对 EEG 频谱功率进行分区，并在头皮水平和皮质源重建后进行统计分析。
我们发现 BP 患者的θ和β频段的功率明显高于 MDD 患者，主要位于前额叶皮层。此外，与非反应者相比，反应者在顶叶区域的δ和θ频段具有更高的功率，而在前额α频段具有较弱的功率。
这些针对小队列的初步发现表明，治疗前 EEG 振荡模式对于 MDD 和 BP 障碍的 rTMS 治疗可能具有一定的预测价值。
