Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran.
Department of Psychology, University of Tehran, Tehran, Iran; Atieh Clinical Neuroscience Center, Tehran, Iran.
J Affect Disord. 2022 Nov 15;317:360-372. doi: 10.1016/j.jad.2022.08.098. Epub 2022 Aug 30.
Rumination is significantly frequent in major depressive disorder (MDD). However, not a lot of studies have investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on rumination.
61 participants with a minimum Hamilton Depression Rating Scale (HAM-D) score of 20 were randomly assigned to sham, bilateral stimulation (BS) or unilateral stimulation (US) groups. EEG, The Ruminative Response Scale (RRS), and HAM-D were administered before and after the 20 sessions of rTMS. Phase locked values (PLV) were calculated as a measure of connectivity.
There was a significant decrease in HAM-D scores in both BS and US. In responders, BS and US differed significantly in RRS total scores, with greater reduction in BS. PLV significantly changed in the default mode network (DMN) in delta, theta, alpha, and beta in BS, in responders of which PLV decreased in the DMN in beta and gamma. Positive correlations between PLV and brooding in delta and theta, and negative correlations between PLV and reflection were found in theta, alpha, and beta. In US, connectivity in the DMN increased in beta, and PLV increased in theta and beta, and decreased in alpha and beta in its responders. Positive correlations between PLV and brooding in the delta and theta, as well as negative correlations between PLV and reflection in theta were observed in the DMN.
US and BS resulted in different modulations in the DMN, however, both could alleviate both rumination and depression. Reductions in the beta and alpha frequency bands in the DMN can be considered as potential EEG-based markers of response to bilateral and unilateral rTMS, respectively.
反刍在重度抑郁症（MDD）中非常频繁。然而，没有很多研究调查重复经颅磁刺激（rTMS）对反刍的影响。
61 名汉密尔顿抑郁评定量表（HAM-D）评分至少为 20 的参与者被随机分配到假刺激、双侧刺激（BS）或单侧刺激（US）组。在 rTMS 20 次治疗前后进行脑电图、反刍反应量表（RRS）和 HAM-D 评估。相位锁定值（PLV）被计算为连接性的度量。
BS 和 US 组的 HAM-D 评分均显著降低。在应答者中，BS 和 US 在 RRS 总分上存在显著差异，BS 的降低更为明显。BS 中默认模式网络（DMN）的 delta、theta、alpha 和 beta 频段的 PLV 显著改变，其中 beta 和 gamma 频段的 DMN 中的 PLV 降低。在 delta 和 theta 频段中，PLV 与沉思呈正相关，而在 theta、alpha 和 beta 频段中，PLV 与反思呈负相关。在 US 中，DMN 中的连接性在 beta 频段增加，PLV 在 theta 和 beta 频段增加，在 alpha 和 beta 频段减少，其应答者中也是如此。在 DMN 中观察到 PLV 与 delta 和 theta 中的沉思呈正相关，以及与 theta 中的反思呈负相关。
BS 和 US 导致 DMN 中的不同调制，但两者均可缓解反刍和抑郁。DMN 中 beta 和 alpha 频段的减少可以分别被视为双侧和单侧 rTMS 反应的潜在基于 EEG 的标志物。
