Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA.
Department of Medical Engineering, University of South Florida, 4202 E. Fowler Avenue, ENG 030, Tampa, FL, USA.
Sci Rep. 2021 Apr 1;11(1):7328. doi: 10.1038/s41598-021-86751-9.
Repetitive transcranial magnetic stimulation (rTMS) is an effective and safe treatment for depression; however, its potential has likely been hindered due to non-optimized targeting, unclear ideal stimulation parameters, and lack of information regarding how the brain is physiologically responding during and after stimulation. While neuroimaging is ideal for obtaining such critical information, existing modalities have been limited due to poor resolutions, along with significant noise interference from the electromagnetic spectrum. In this study, we used a novel diffuse optical tomography (DOT) device in order to advance our understanding of the neurophysiological effects of rTMS in depression. Healthy and depressed subjects aged 18-70 were recruited. Treatment parameters were standardized with targeting of the left dorsolateral prefrontal cortex with a magnetic field intensity of 100% of motor threshold, pulse frequency of 10 per second, a 4 s stimulation time and a 26 s rest time. DOT imaging was simultaneously acquired from the contralateral dorsolateral prefrontal cortex. Six healthy and seven depressed subjects were included for final analysis. Hemoglobin changes and volumetric three-dimensional activation patterns were successfully captured. Depressed subjects were observed to have a delayed and less robust response to rTMS with a decreased volume of activation compared to healthy subjects. In this first-in-human study, we demonstrated the ability of DOT to safely and reliably capture and compare cortical response patterns to rTMS in depressed and healthy subjects. We introduced this emerging optical functional imaging modality as a novel approach to investigating targeting, new treatment parameters, and physiological effects of rTMS in depression.
重复经颅磁刺激（rTMS）是一种有效且安全的抑郁症治疗方法；然而，由于靶向非优化、理想刺激参数不明确以及缺乏关于大脑在刺激期间和之后如何生理反应的信息，其潜力可能受到了阻碍。虽然神经影像学是获取此类关键信息的理想方法，但由于分辨率差，以及电磁光谱的显著噪声干扰，现有的模态受到了限制。在这项研究中，我们使用了一种新型的漫射光学断层扫描（DOT）设备，以深入了解 rTMS 在抑郁症中的神经生理效应。招募了年龄在 18-70 岁的健康和抑郁受试者。治疗参数标准化，靶向左侧背外侧前额叶皮层，磁场强度为运动阈值的 100%，脉冲频率为每秒 10 次，刺激时间为 4 秒，休息时间为 26 秒。同时从对侧背外侧前额叶皮层采集 DOT 图像。最终有 6 名健康受试者和 7 名抑郁受试者纳入分析。成功捕获了血红蛋白变化和容积三维激活模式。与健康受试者相比，抑郁受试者对 rTMS 的反应延迟且较弱，激活体积减小。在这项首次人体研究中，我们证明了 DOT 具有安全可靠地捕获和比较 rTMS 在抑郁和健康受试者中皮质反应模式的能力。我们引入了这种新兴的光学功能成像模态，作为一种研究 rTMS 在抑郁症中的靶向、新治疗参数和生理效应的新方法。
