Aşık Murat, İlhan Reyhan, Günver Mehmet Güven, Orhan Özden, Esmeray Muhammed Taha, Kalaba Öznur, Arıkan Mehmet Kemal
Istanbul Medeniyet University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey.
Kemal Arıkan Psychiatry Clinic, Istanbul, Turkey.
Clin EEG Neurosci. 2025 May;56(3):207-216. doi: 10.1177/15500594241298977. Epub 2024 Nov 20.
Brain morphological biomarkers could contribute to understanding the treatment response in patients with obsessive-compulsive disorder (OCD). Multimodal neuroimaging addresses this issue by providing more comprehensive information regarding neural processes and structures. The present study aims to investigate whether patients responsive to deep Transcranial Magnetic Stimulation (TMS) differ from non-responsive individuals in terms of electrophysiology and brain morphology. Secondly, to test whether multimodal neuroimaging is superior to unimodal neuroimaging in predicting response to deep TMS. Thirty-two OCD patients who underwent thirty sessions of deep TMS treatment were included in the study. Based on a minimum 50% reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores after treatment, patients were grouped as responders (n = 25) and non-responders (n = 7). The baseline resting state qEEG and magnetic resonance imaging (MRI) records of patients were recorded. Independent sample t-test is used to compare the groups. Then, three logistic regression model were calculated for only QEEG markers, only MRI markers, and both QEEG/MRI markers. The predictive values of the three models were compared. OCD patients who responded to deep TMS treatment had increased Alpha-2 power in the left temporal area and increased volume in the left temporal pole, entorhinal area, and parahippocampal gyrus compared to non-responders. The logistic regression model showed better prediction performance when both QEEG and MRI markers were included. This study addresses the gap in the literature regarding new functional and structural neuroimaging markers and highlights the superiority of multimodal neuroimaging to unimodal neuroimaging techniques in predicting treatment response.
脑形态生物标志物有助于理解强迫症（OCD）患者的治疗反应。多模态神经成像通过提供有关神经过程和结构的更全面信息来解决这一问题。本研究旨在调查对深部经颅磁刺激（TMS）有反应的患者在电生理学和脑形态方面是否与无反应者不同。其次，测试多模态神经成像在预测深部TMS反应方面是否优于单模态神经成像。32名接受了30次深部TMS治疗的OCD患者被纳入研究。根据治疗后耶鲁-布朗强迫症量表（Y-BOCS）评分至少降低50%，患者被分为反应者（n = 25）和无反应者（n = 7）。记录了患者的基线静息态定量脑电图（qEEG）和磁共振成像（MRI）记录。使用独立样本t检验比较两组。然后，针对仅qEEG标记物、仅MRI标记物以及qEEG/MRI标记物计算了三个逻辑回归模型。比较了这三个模型的预测值。与无反应者相比，对深部TMS治疗有反应的OCD患者左颞区的α-2功率增加，左颞极、内嗅区和海马旁回的体积增加。当同时纳入qEEG和MRI标记物时，逻辑回归模型显示出更好的预测性能。本研究填补了文献中关于新的功能和结构神经成像标记物的空白，并突出了多模态神经成像在预测治疗反应方面相对于单模态神经成像技术的优越性。
