Wang Zhongheng, Zhang Dongning, Guan Muzhen, Ren Xiaojiao, Li Dan, Yin Kaiming, Zhou Ping, Li Baojuan, Wang Huaning
Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China.
Department of Mental Health, Xi'an Medical College, Xi'an, China.
Front Psychiatry. 2023 May 12;14:1163067. doi: 10.3389/fpsyt.2023.1163067. eCollection 2023.
Repetitive transcranial magnetic stimulation (rTMS) is an effective therapy in improving depressive symptoms in MDD patients, but the intrinsic mechanism is still unclear. In this study, we investigated the influence of rTMS on brain gray matter volume for alleviating depressive symptoms in MDD patients using structural magnetic resonance imaging (sMRI) data.
Patients with first episode, unmedicated patients with MDD ( = 26), and healthy controls ( = 31) were selected for this study. Depressive symptoms were assessed before and after treatment by using the HAMD-17 score. High-frequency rTMS treatment was conducted in patients with MDD over 15 days. The rTMS treatment target is located at the F3 point of the left dorsolateral prefrontal cortex. Structural magnetic resonance imaging (sMRI) data were collected before and after treatment to compare the changes in brain gray matter volume.
Before treatment, patients with MDD had significantly reduced gray matter volumes in the right fusiform gyrus, left and right inferior frontal gyrus (triangular part), left inferior frontal gyrus (orbital part), left parahippocampal gyrus, left thalamus, right precuneus, right calcarine fissure, and right median cingulate gyrus compared with healthy controls ( < 0.05). After rTMS treatment, significant growth in gray matter volume of the bilateral thalamus was observed in depressed patients ( < 0.05).
Bilateral thalamic gray matter volumes were enlarged in the thalamus of MDD patients after rTMS treatment and may be the underlying neural mechanism for the treatment of rTMS on depression.
重复经颅磁刺激（rTMS）是改善重度抑郁症（MDD）患者抑郁症状的有效疗法，但其内在机制仍不清楚。在本研究中，我们使用结构磁共振成像（sMRI）数据，研究rTMS对MDD患者脑灰质体积的影响，以减轻其抑郁症状。
本研究选取首次发作、未用药的MDD患者（n = 26）和健康对照者（n = 31）。治疗前后采用汉密尔顿抑郁量表17项版本（HAMD-17）评分评估抑郁症状。MDD患者接受高频rTMS治疗，为期15天。rTMS治疗靶点位于左侧背外侧前额叶皮质的F3点。在治疗前后收集sMRI数据，以比较脑灰质体积的变化。
治疗前，与健康对照者相比，MDD患者右侧梭状回、左右额下回（三角部）、左侧额下回（眶部）、左侧海马旁回、左侧丘脑、右侧楔前叶、右侧距状裂和右侧中央扣带回的灰质体积显著减少（P < 0.05）。rTMS治疗后，抑郁症患者双侧丘脑灰质体积显著增加（P < 0.05）。
rTMS治疗后，MDD患者丘脑的双侧丘脑灰质体积增大，这可能是rTMS治疗抑郁症的潜在神经机制。
