Che QiangYan, Xi Chunhua, Sun Yunlin, Zhao Xingyu, Wang Lei, Wu Ke, Mao Junyu, Huang Xinyu, Wang Kai, Tian Yanghua, Ye Rong, Yu Fengqiong
School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, China.
Department of Neurology, The Third Affiliated Hospital of Anhui Medical University, Hefei, China.
Behav Brain Res. 2025 Apr 12;483:115463. doi: 10.1016/j.bbr.2025.115463. Epub 2025 Feb 5.
Anhedonia, a core feature of major depressive disorder (MDD), presents significant treatment challenges with conventional methods. Circuit-targeted, personalized repetitive transcranial magnetic stimulation (rTMS) has shown potentiation by focusing on disruptions in specific networks related to anhedonia. However, how rTMS modulates brain network dynamics in anhedonia is not yet fully understood. This research sought to explore these effects using EEG microstate analysis. In this double-blind, randomized, sham-controlled study, resting-state functional MRI was employed to pinpoint the left dorsolateral prefrontal cortex (DLPFC) region that exhibited the strongest functional connectivity to the nucleus accumbens (NAcc), used as the target for rTMS stimulation. Rest-state EEG data from 49 depressive patients with anhedonia(active=26, sham=23) were analyzed both at baseline and after treatment. In addition, a group of 15 healthy participants was included to serve as baseline controls. Resting-state EEG data were collected at baseline and post-treatment. Using polarity-insensitive k-means clustering, EEG microstates were segmented into five categories (A-E). Circuit-targeted rTMS significantly alleviated symptoms of anhedonia and depression. Compared to healthy controls, patients with anhedonia showed reduced microstate B and C occurrence, along with increased microstate D duration. After rTMS targeting the DLPFC-NAcc pathway, the active treatment group exhibited normalization of microstate C occurrence and a reduction in microstate E duration. Notably, the increase in microstate C was significantly correlated with improvements in anticipatory anhedonia, and these changes were observed specifically in treatment responders. The findings suggest that microstate C is linked to anhedonia and could serve as a reliable biomarker for personalized rTMS treatment. These results provide insights into the neural mechanisms underlying rTMS for anhedonia and highlight the potential of EEG microstate analysis in guiding personalized treatment strategies for depression.
快感缺失是重度抑郁症（MDD）的核心特征，给传统治疗方法带来了重大挑战。针对特定脑回路的个性化重复经颅磁刺激（rTMS）通过聚焦与快感缺失相关的特定网络中断，已显示出增效作用。然而，rTMS如何调节快感缺失中的脑网络动力学尚未完全清楚。本研究旨在利用脑电图微状态分析来探索这些效应。在这项双盲、随机、假对照研究中，采用静息态功能磁共振成像来确定与伏隔核（NAcc）功能连接最强的左侧背外侧前额叶皮层（DLPFC）区域，将其作为rTMS刺激的靶点。对49例伴有快感缺失的抑郁症患者（实验组 = 26例，假刺激组 = 23例）的静息态脑电图数据在基线和治疗后进行了分析。此外，纳入了一组15名健康参与者作为基线对照。在基线和治疗后收集静息态脑电图数据。使用极性不敏感的k均值聚类，将脑电图微状态分为五类（A - E）。针对特定脑回路的rTMS显著减轻了快感缺失和抑郁症状。与健康对照组相比，伴有快感缺失的患者微状态B和C的出现频率降低，微状态D的持续时间增加。在针对DLPFC - NAcc通路进行rTMS治疗后，实验组微状态C的出现频率恢复正常，微状态E的持续时间缩短。值得注意的是，微状态C的增加与预期性快感缺失的改善显著相关，并且这些变化在治疗有反应者中尤为明显。研究结果表明，微状态C与快感缺失有关，可作为个性化rTMS治疗的可靠生物标志物。这些结果为rTMS治疗快感缺失的神经机制提供了见解，并突出了脑电图微状态分析在指导抑郁症个性化治疗策略方面的潜力。
Behav Brain Res. 2024-5-8
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