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重复经颅磁刺激对广泛性焦虑障碍患者额叶和颞叶时变脑电网络的调节作用:一项初步研究

Repetitive Transcranial Magnetic Stimulation Modulates Frontal and Temporal Time-Varying EEG Network in Generalized Anxiety Disorder: A Pilot Study.

作者信息

Song Penghui, Tong Han, Zhang Luyan, Lin Hua, Hu Ningning, Zhao Xin, Hao Wensi, Xu Peng, Wang Yuping

机构信息

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Central Laboratory, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

Front Psychiatry. 2022 Jan 14;12:779201. doi: 10.3389/fpsyt.2021.779201. eCollection 2021.

Abstract

Generalized Anxiety Disorder (GAD) is a highly prevalent yet poorly understood chronic mental disorder. Previous studies have associated GAD with excessive activation of the right dorsolateral prefrontal cortex (DLPFC). This study aimed to investigate the effect of low-frequency repetitive transcranial magnetic stimulation (repetitive TMS, rTMS) targeting the right DLPFC on clinical symptoms and TMS-evoked time-varying brain network connectivity in patients with GAD. Eleven patients with GAD received 1 Hz rTMS treatment targeting the right DLPFC for 10 days. The severity of the clinical symptoms was evaluated using the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) at baseline, right after treatment, and at the one-month follow-up. Co-registration of single-pulse TMS (targeting the right DLPFC) and electroencephalography (TMS-EEG) was performed pre- and post-treatment in these patients and 11 healthy controls. Time-varying brain network connectivity was analyzed using the adaptive directed transfer function. The scores of HAMA and HAMD significantly decreased after low-frequency rTMS treatment, and these improvements in ratings remained at the one-month follow-up. Analyses of the time-varying EEG network in the healthy controls showed a continuous weakened connection information outflow in the left frontal and mid-temporal regions. Compared with the healthy controls, the patients with GAD showed weakened connection information outflow in the left frontal pole and the posterior temporal pole at baseline. After 10-day rTMS treatment, the network patterns showed weakened connection information outflow in the left frontal and temporal regions. The time-varying EEG network changes induced by TMS perturbation targeting right DLPFC in patients with GAD were characterized by insufficient information outflow in the left frontal and temporal regions. Low-frequency rTMS targeting the right DLPFC reversed these abnormalities and improved the clinical symptoms of GAD.

摘要

广泛性焦虑障碍(GAD)是一种高度常见但了解不足的慢性精神障碍。先前的研究已将GAD与右侧背外侧前额叶皮质(DLPFC)的过度激活相关联。本研究旨在探讨针对右侧DLPFC的低频重复经颅磁刺激(重复TMS,rTMS)对GAD患者临床症状及TMS诱发的时变脑网络连通性的影响。11例GAD患者接受针对右侧DLPFC的1Hz rTMS治疗,为期10天。在基线、治疗结束后及1个月随访时,使用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评估临床症状的严重程度。在这些患者及11名健康对照者治疗前后进行单脉冲TMS(针对右侧DLPFC)与脑电图(TMS-EEG)的联合登记。使用自适应定向传递函数分析时变脑网络连通性。低频rTMS治疗后,HAMA和HAMD评分显著降低,且这些评分改善在1个月随访时仍持续存在。对健康对照者时变脑电网络的分析显示,左额叶和颞中区的连接信息流出持续减弱。与健康对照者相比,GAD患者在基线时左额极和颞后极的连接信息流出减弱。经过10天的rTMS治疗后,网络模式显示左额叶和颞叶区域的连接信息流出减弱。GAD患者中针对右侧DLPFC的TMS扰动所诱发的时变脑电网络变化,其特征为左额叶和颞叶区域的信息流出不足。针对右侧DLPFC的低频rTMS逆转了这些异常并改善了GAD的临床症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c45f/8795864/7b91ed99b92b/fpsyt-12-779201-g0001.jpg

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