Department of Neuropsychiatry, Faculty of Medicine, Kansai Medical University, Moriguchi, Japan,
Department of Neuropsychiatry, Faculty of Medicine, Kansai Medical University, Moriguchi, Japan.
Neuropsychobiology. 2024;83(3-4):170-178. doi: 10.1159/000541006. Epub 2024 Oct 7.
The left dorsolateral prefrontal cortex (lDLPFC) is a commonly targeted brain region for repetitive transcranial magnetic stimulation (rTMS) for depression. The lDLPFC has been identified using the "5-cm rule." However, identification of the lDLPFC may deviate from the ideal stimulation site localized by neuronavigation. Therefore, we aimed to compare this method with other methods and examine the relationship between deviation from the ideal stimulation site and treatment effects. While most existing studies have focused on participants of European descent, this study focused on Japanese participants.
The study participants were 16 patients who underwent rTMS and had the stimulus location identified using the 5-cm method. The lDLPFC was identified by the F3 electrode position and neuronavigation in addition to the 5-cm rule, and these locations were compared. We then performed a correlation analysis of the distance between the sites identified by the 5-cm method and by neuronavigation, as well as changes in scores on the 17-item Hamilton Depression Scale (HAMD-17).
The lDLPFC identified by the F3 site and neuronavigation was approximately 3 cm more anterolateral than that identified by the 5-cm method. A significant correlation was found between the distance between the sites identified by the 5-cm method and neuronavigation and the rate of change in HAMD-17 scores.
The ideal stimulation site may be approximately 3 cm anterior to the site identified by the 5-cm method, and stimulation of the F3 site may be a valid alternative to the 5-cm method.
左背外侧前额叶皮层（lDLPFC）是经颅重复磁刺激（rTMS）治疗抑郁症的常用靶向脑区。lDLPFC 已通过“5 厘米规则”进行了识别。然而，lDLPFC 的识别可能与神经导航定位的理想刺激部位存在偏差。因此，我们旨在将这种方法与其他方法进行比较，并研究与理想刺激部位的偏差和治疗效果之间的关系。虽然大多数现有研究都集中在欧洲血统的参与者身上，但本研究则专注于日本参与者。
研究参与者为 16 名接受 rTMS 治疗的患者，他们的刺激位置通过 5 厘米方法确定。除了 5 厘米规则外，还通过 F3 电极位置和神经导航来识别 lDLPFC，并对这些位置进行比较。然后，我们对 5 厘米方法和神经导航确定的位置之间的距离以及 17 项汉密尔顿抑郁量表（HAMD-17）评分的变化进行了相关性分析。
F3 位点和神经导航确定的 lDLPFC 比 5 厘米方法确定的位置大约向前外侧 3 厘米。5 厘米方法和神经导航确定的位置之间的距离与 HAMD-17 评分变化率之间存在显著相关性。
理想的刺激部位可能比 5 厘米方法确定的部位向前约 3 厘米，刺激 F3 部位可能是 5 厘米方法的有效替代方法。
