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Transcranial Magnetic Stimulation of Left Dorsolateral Prefrontal Cortex Induces Brain Morphological Changes in Regions Associated with a Treatment Resistant Major Depressive Episode: An Exploratory Analysis.

TitleTranscranial Magnetic Stimulation of Left Dorsolateral Prefrontal Cortex Induces Brain Morphological Changes in Regions Associated with a Treatment Resistant Major Depressive Episode: An Exploratory Analysis.
Publication TypeJournal Article
Year of Publication2016
AuthorsLan MJ, Chhetry BThapa, Liston C, J Mann J, Dubin M
JournalBrain Stimul
Volume9
Issue4
Pagination577-83
Date Published2016 Jul-Aug
ISSN1876-4754
KeywordsAdult, Cerebral Cortex, Depressive Disorder, Major, Depressive Disorder, Treatment-Resistant, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Transcranial Magnetic Stimulation
Abstract

BACKGROUND: Repetitive transcranial magnetic stimulation (TMS) is an FDA-approved antidepressant treatment but little is known of its mechanism of action. Specifically, downstream effects of TMS remain to be elucidated.

OBJECTIVE/HYPOTHESIS: This study aims to identify brain structural changes from TMS treatment of a treatment resistant depressive episode through an exploratory analysis.

METHODS: Twenty-seven subjects in a DSM-IV current major depressive episode and on a stable medication regimen had a 3T magnetic resonance T1 structural scan before and after five weeks of standard TMS treatment to the left dorsolateral prefrontal cortex. Twenty-seven healthy volunteer (HVs) subjects had the same brain MRI acquisition. Voxel-based morphometry was performed using high dimensional non-linear diffusomorphic anatomical registration (DARTEL).

RESULTS: Six clusters of gray matter volume (GMV) that were lower in pre-treatment MRIs of depressed subjects than in HVs. GMV in four of these regions increased in MDD after TMS treatment by 3.5-11.2%. The four brain regions that changed with treatment were centered in the left anterior cingulate cortex, the left insula, the left superior temporal gyrus and the right angular gyrus. Increases in the anterior cingulate GMV with TMS correlated with improvement in depression severity.

CONCLUSIONS: To our knowledge, this is the first study of brain structural changes during TMS treatment of depression. The affected brain areas are involved in cognitive appraisal, decision-making and subjective experience of emotion. These effects may have potential relevance for the antidepressant action of TMS.

DOI10.1016/j.brs.2016.02.011
Alternate JournalBrain Stimul
PubMed ID27017072
PubMed Central IDPMC5554068
Grant ListK23 MH105688 / MH / NIMH NIH HHS / United States
K99 MH097822 / MH / NIMH NIH HHS / United States
R00 MH097822 / MH / NIMH NIH HHS / United States
UL1 TR000457 / TR / NCATS NIH HHS / United States