Li Weicheng, Yin Yanan, You Zerui, Zhang Min, Wang Chengyu, Lan Xiaofeng, Mai Siming, Zhang Fan, Hu Zhibo, Liu Guanxi, Chen Xiaoyu, Liu Haiyan, Luo Zhanjie, Zeng Yexian, Chen Yiying, Chen Yifang, Shao Robin, Lu Hanna, McIntyre Roger S, Zhou Yanling, Ning Yuping
Department of Child and Adolescent Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Gen Psychiatr. 2025 Apr 28;38(2):e101749. doi: 10.1136/gpsych-2024-101749. eCollection 2025.
The heterogeneity of depression limits the treatment outcomes of intermittent theta burst stimulation (iTBS) and hinders the identification of predictive factors. This study investigated functional network connectivity and predictors of iTBS treatment outcomes in adolescents and young adults with depression.
This study aimed to identify default mode network (DMN)-based connectivity patterns associated with varying iTBS treatment outcomes in depression.
Data from a randomised controlled trial of iTBS in depression (n=82) were analysed using a data-driven approach to classify homogeneous subgroups based on the DMN. Connectivity subgroups were compared on depressive symptoms and cognitive function at pretreatment and post-treatment. Furthermore, the predictive significance of baseline inflammatory cytokines on post-treatment outcomes was evaluated.
Two distinct subgroups were identified. Subgroup 1 exhibited high heterogeneity and greater centrality in the posterior cingulate cortex and retrosplenial cortex, while subgroup 2 showed more homogeneous connectivity patterns and greater centrality in the temporoparietal junction and posterior inferior parietal lobule. No main effect for subgroup, treatment or subgroup×treatment interaction was revealed in the improvement of depressive symptoms. A significant subgroup×treatment interaction related to symbol coding improvement was detected (F=5.22, p=0.026). Within subgroup 1, the active group showed significantly greater improvement in symbol coding compared with the sham group (t=2.30, p=0.028), while baseline levels of interleukin-6 and C-reactive protein emerged as significant indicators for predicting improvements in symbolic coding (R=0.35, RMSE (root-mean-square error)=5.72, p=0.013). Subgroup 2 showed no significant findings in terms of cognitive improvement or inflammatory cytokines predictions.
Data-driven network analyses offer valuable insights into iTBS treatment outcomes in depression, providing clues for predicting cognitive improvements from an inflammatory perspective.
ChiCTR2100042346.
抑郁症的异质性限制了间歇性θ波爆发刺激（iTBS）的治疗效果，并阻碍了预测因素的识别。本研究调查了青少年和青年抑郁症患者中iTBS治疗效果的功能网络连通性及预测因素。
本研究旨在识别基于默认模式网络（DMN）的连通性模式，这些模式与抑郁症中不同的iTBS治疗效果相关。
使用数据驱动方法对抑郁症iTBS随机对照试验（n = 82）的数据进行分析，以基于DMN对同质亚组进行分类。在治疗前和治疗后，比较连通性子组在抑郁症状和认知功能方面的差异。此外，评估基线炎症细胞因子对治疗后结果的预测意义。
识别出两个不同的亚组。亚组1表现出高度异质性，在后扣带回皮质和压后皮质中具有更高的中心性，而亚组2显示出更均匀的连通性模式，在颞顶联合区和顶叶后下小叶中具有更高的中心性。在抑郁症状改善方面，未发现亚组、治疗或亚组×治疗交互作用的主要效应。检测到与符号编码改善相关的显著亚组×治疗交互作用（F = 5.22，p = 0.026）。在亚组1中，与假刺激组相比，主动刺激组在符号编码方面有显著更大的改善（t = 2.30，p = 0.028），而白细胞介素-6和C反应蛋白的基线水平成为预测符号编码改善的显著指标（R = 0.35，均方根误差（RMSE）= 5.72，p = 0.013）。亚组2在认知改善或炎症细胞因子预测方面未发现显著结果。
数据驱动的网络分析为抑郁症中iTBS的治疗效果提供了有价值的见解，从炎症角度为预测认知改善提供了线索。
ChiCTR2100042346。
