Yamazaki Ryuichi, Inoue Yuki, Matsuda Yuki, Kodaka Fumitoshi, Kitamura Yuzuki, Kita Yosuke, Shigeta Masahiro, Kito Shinsuke
Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan.
Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan.
Psychiatry Res. 2022 Apr;310:114444. doi: 10.1016/j.psychres.2022.114444. Epub 2022 Feb 13.
The factors associated with the clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) in patients with major depressive disorder (MDD) remain largely unexplored. Therefore, this study aimed to examine whether rTMS can change the functional laterality of the prefrontal hemodynamic response and whether baseline functional laterality can predict the clinical outcomes of rTMS using functional near-infrared spectroscopy (fNIRS). We included 19 patients with MDD who were treated with high-frequency rTMS. The verbal fluency task was used as the activation task. We calculated the laterality index (LI) based on the task-related oxygenation response in the frontal region. First, the LI was compared before and after rTMS treatment. Second, the reduction in the Montgomery-Åsberg Depression Rating Scale (MADRS) score was compared between the rightward dominance group (pre-LI < 0) and the leftward dominance group (pre-LI ≥ 0). The findings showed a significant change in the LI after rTMS treatment. The rightward dominance group had a significantly greater reduction in MADRS score than the leftward dominance group. Subsequently, the laterality of the task-related hemodynamic response of the prefrontal region shifted leftward following left high-frequency rTMS treatment. Thus, the pre-LI calculated using fNIRS data is a possible predictor of rTMS outcomes in patients with MDD.
与重度抑郁症（MDD）患者重复经颅磁刺激（rTMS）临床结局相关的因素在很大程度上仍未得到探索。因此，本研究旨在使用功能近红外光谱（fNIRS）检查rTMS是否能改变前额叶血流动力学反应的功能偏侧性，以及基线功能偏侧性是否能预测rTMS的临床结局。我们纳入了19例接受高频rTMS治疗的MDD患者。言语流畅性任务用作激活任务。我们根据额叶区域与任务相关的氧合反应计算偏侧性指数（LI）。首先，比较rTMS治疗前后的LI。其次，比较右优势组（治疗前LI<0）和左优势组（治疗前LI≥0）之间蒙哥马利-阿斯伯格抑郁量表（MADRS）评分的降低情况。研究结果显示，rTMS治疗后LI有显著变化。右优势组的MADRS评分降低幅度明显大于左优势组。随后，左侧高频rTMS治疗后，前额叶区域与任务相关的血流动力学反应的偏侧性向左偏移。因此，使用fNIRS数据计算的治疗前LI可能是MDD患者rTMS结局的一个预测指标。
