Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, the Netherlands; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, the Netherlands.
Brain Stimul. 2020 Mar-Apr;13(2):318-326. doi: 10.1016/j.brs.2019.10.017. Epub 2019 Oct 24.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique to treat psychiatric disorders, such as obsessive-compulsive disorder (OCD). However, the rTMS response varies across subjects.
OBJECTIVE/HYPOTHESIS: We hypothesize that baseline network properties of the rTMS target may help understand this variation and predict response.
Excitatory rTMS to the dorsolateral prefrontal cortex (dlPFC) was applied in 19 unmedicated OCD patients, while inhibitory dlPFC-rTMS was applied in 17 healthy controls. The vertex was used as an active control target (19 patients, 18 controls). The rTMS response was operationalized as the individual change in state distress rating during an emotion regulation task. At baseline, subjects underwent resting-state functional MRI. The brain network was constructed by calculating wavelet coherence between regional activity of regions in the Brainnetome atlas. Local and integrative static connectivity and the dynamic network role of the target were calculated. Baseline target region network features were non-parametrically correlated to rTMS response.
In the dlPFC-stimulated patients, greater local connectivity (Kendall's Tau = -0.415, p = 0.013) and less promiscuous role of the target (Kendall's Tau = 0.389, p = 0.025) at baseline were related to greater distress reduction after excitatory rTMS. There were no significant associations in healthy subjects nor in the active control stimulated patients.
Pre-treatment network topological indices predict rTMS-induced emotional response changes in OCD, such that greater baseline resting-state local connectivity and less temporal integration of the target region imply greater stimulation effects. These results may lead the way towards personalized neuromodulation in OCD.
重复经颅磁刺激（rTMS）是一种非侵入性的神经调节技术，可用于治疗精神疾病，如强迫症（OCD）。然而，rTMS 的反应因个体而异。
目的/假设：我们假设 rTMS 靶点的基线网络特性有助于理解这种变化并预测反应。
在 19 名未接受药物治疗的 OCD 患者中应用兴奋性 rTMS 刺激背外侧前额叶皮质（dlPFC），在 17 名健康对照中应用抑制性 dlPFC-rTMS。顶点被用作主动对照靶点（19 名患者，18 名对照）。rTMS 反应被定义为情绪调节任务中个体状态困扰评分的变化。在基线时，受试者进行静息态功能磁共振成像。通过计算脑网络图谱中区域活动之间的小波相干性来构建脑网络。计算了局部和整体静态连通性以及目标的动态网络作用。将基线目标区域网络特征与 rTMS 反应进行非参数相关分析。
在 dlPFC 刺激的患者中，更大的局部连通性（Kendall's Tau = -0.415，p = 0.013）和目标更小的混杂作用（Kendall's Tau = 0.389，p = 0.025）与兴奋性 rTMS 后更大的痛苦减轻相关。在健康对照组和活性对照刺激的患者中均无显著相关性。
治疗前网络拓扑指数预测 OCD 中 rTMS 诱导的情绪反应变化，即更大的静息状态局部连通性和目标区域的更少时间整合意味着更大的刺激效果。这些结果可能为 OCD 的个性化神经调节开辟道路。
