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重复经颅磁刺激干预对使用静息态功能磁共振成像测量的青少年重度抑郁症患者功能神经影像活动的影响。

Effects of rTMS Intervention on Functional Neuroimaging Activities in Adolescents with Major Depressive Disorder Measured Using Resting-State fMRI.

作者信息

Lu Fengmei, Cui Qian, Zou Yang, Guo Yuanhong, Luo Wei, Yu Yue, Gao Jingjing, Cai Xiao, Fu Linna, Yuan Shuai, Huang Juan, Zhang Yajun, Xie Jing, Sheng Wei, Tang Qin, Gao Qing, He Zongling, Chen Huafu

机构信息

The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.

School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu 611731, China.

出版信息

Bioengineering (Basel). 2023 Nov 29;10(12):1374. doi: 10.3390/bioengineering10121374.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (L-DLPFC) is commonly used for the clinical treatment of major depressive disorder (MDD). The neuroimaging biomarkers and mechanisms of rTMS are still not completely understood. This study aimed to explore the functional neuroimaging changes induced by rTMS in adolescents with MDD. A total of ten sessions of rTMS were administrated to the L-DLPFC in thirteen adolescents with MDD once a day for two weeks. All of them were scanned using resting-state functional magnetic resonance imaging at baseline and after rTMS treatment. The regional homogeneity (ReHo), amplitude of low-frequency fluctuation (ALFF), and the subgenual anterior cingulate cortex (sgACC)-based functional connectivity (FC) were computed as neuroimaging indicators. The correlation between changes in the sgACC-based FC and the improvement in depressive symptoms was also analyzed. After rTMS treatment, ReHo and ALFF were significantly increased in the L-DLPFC, the left medial prefrontal cortex, bilateral medial orbital frontal cortex, and the left ACC. ReHo and ALFF decreased mainly in the left middle occipital gyrus, the right middle cingulate cortex (MCC), bilateral calcarine, the left cuneus, and the left superior occipital gyrus. Furthermore, the FCs between the left sgACC and the L-DLPFC, the right IFGoper, the left MCC, the left precuneus, bilateral post-central gyrus, the left supplementary motor area, and the left superior marginal gyrus were enhanced after rTMS treatment. Moreover, the changes in the left sgACC-left MCC FC were associated with an improvement in depressive symptoms in early improvers. This study showed that rTMS treatment in adolescents with MDD causes changes in brain activities and sgACC-based FC, which may provide basic neural biomarkers for rTMS clinical trials.

摘要

重复经颅磁刺激(rTMS)作用于左侧背外侧前额叶皮质(L-DLPFC)常用于重度抑郁症(MDD)的临床治疗。rTMS的神经影像学生物标志物和机制仍未完全明确。本研究旨在探讨rTMS在青少年MDD患者中诱导的功能神经影像变化。对13例青少年MDD患者的L-DLPFC进行总共10次rTMS治疗,每天1次,持续两周。所有患者在基线期和rTMS治疗后均接受静息态功能磁共振成像扫描。计算局部一致性(ReHo)、低频振幅(ALFF)以及基于膝下前扣带回皮质(sgACC)的功能连接(FC)作为神经影像指标。还分析了基于sgACC的FC变化与抑郁症状改善之间的相关性。rTMS治疗后,L-DLPFC、左侧内侧前额叶皮质、双侧内侧眶额皮质和左侧前扣带回皮质的ReHo和ALFF显著增加。ReHo和ALFF主要在左侧枕中回、右侧中央扣带回皮质(MCC)、双侧距状裂、左侧楔叶和左侧枕上回降低。此外,rTMS治疗后,左侧sgACC与L-DLPFC、右侧额下回岛盖部、左侧MCC、左侧楔前叶、双侧中央后回、左侧辅助运动区和左侧缘上回之间的FC增强。而且,早期改善者中左侧sgACC-左侧MCC FC的变化与抑郁症状的改善相关。本研究表明,rTMS治疗青少年MDD会引起大脑活动和基于sgACC的FC变化,这可能为rTMS临床试验提供基础神经生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cf4/10740826/4bce2ef1676b/bioengineering-10-01374-g001.jpg

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