The Effects of Functionally Guided, Connectivity-Based rTMS on Amygdala Activation
Beynel L, Campbell E, Naclerio M, Galla JT, Ghosal A, Michael AM, Kimbrel NA, Davis SW, Appelbaum LG. The Effects of Functionally Guided, Connectivity-Based rTMS on Amygdala Activation. Brain Sci. 2021 Apr 13;11(4):494. doi: 10.3390/brainsci11040494. PMID: 33924639.
- “While repetitive transcranial magnetic stimulation (rTMS) is widely used to treat psychiatric disorders, innovations are needed to improve its efficacy. An important limitation is that while psychiatric disorders are associated with fronto-limbic dysregulation, rTMS does not have sufficient depth penetration to modulate affected subcortical structures.
- “The objective of this pilot study was to test whether task-related, connectivity-based rTMS could modulate amygdala activation through its connectivity with the medial prefrontal cortex (mPFC).”
- “Significant increases in both the mPFC and amygdala were found for active rTMS compared to sham, offering promising preliminary evidence that functional connectivity-based targeting may provide a useful approach to treat network dysregulation. Further research is needed to better understand connectivity influences on rTMS effects to leverage this information to improve therapeutic applications.”
Statistical Analysis of Graph-Theoretic Indices to Study EEG-TMS Connectivity in Patients With Depression
Olejarczyk E, Jozwik A, Valiulis V, Dapsys K, Gerulskis G, Germanavicius A. Statistical Analysis of Graph-Theoretic Indices to Study EEG-TMS Connectivity in Patients With Depression. Front Neuroinform. 2021 Apr 8;15:651082. doi: 10.3389/fninf.2021.651082. PMID: 33897399; PMCID: PMC8060557.
- “The objective of this work was to demonstrate the usefulness of a novel statistical method to study the impact of transcranial magnetic stimulation (TMS) on brain connectivity in patients with depression using different stimulation protocols.
- “Electroencephalography (EEG) connectivity analysis was performed using Directed Transfer Function (DTF) and a set of 21 indices based on graph theory.”
- “Our new statistical approach allowed for selection of the best set of graph-based indices derived from DTF, and for differentiation between conditions (i.e., before and after TMS) and between TMS protocols. The effects of TMS was found to differ based on frequency band.”
- “A set of four brain asymmetry measures were particularly useful to study protocol- and frequency-dependent effects of TMS on brain connectivity.”
- “The new approach would allow for better evaluation of the therapeutic effects of TMS and choice of the most appropriate stimulation protocol.”
Peripheral endocannabinoid serum level in association with repetitive transcranial magnetic stimulation (rTMS) treatment in patients with major depressive disorder
Lazary J, Elemery M, Dome P, Kiss S, Gonda X, Tombor L, Pogany L, Becskereki G, Toth B, Faludi G. Peripheral endocannabinoid serum level in association with repetitive transcranial magnetic stimulation (rTMS) treatment in patients with major depressive disorder. Sci Rep. 2021 Apr 23;11(1):8867. doi: 10.1038/s41598-021-87840-5. PMID: 33893327; PMCID: PMC8065048.
- “Repetitive transcranial magnetic stimulation (rTMS) is an effective and well tolerable biological intervention in major depressive disorder (MDD) contributing to rapid symptom improvement. Molecular mechanisms underpinning the therapeutic effects of rTMS have still not been clarified.”
- “Recently published animal data implicated relevant associations with changes in endocannabinoid (eCB) brain levels during rTMS treatment, human studies, however, have not been published.”
- “In our study we assessed the detailed phenotypic spectrum of MDD and serum 2-arachidnoylglycerol (2-AG) and anandamide (AEA) levels in 18 patients with treatment-resistant depression before, immediately following, and two weeks after completion of a 10-day rTMS treatment.”
- “We found significant associations between serum 2-AG level changes from pretreatment to 2 weeks after treatment and symptom reduction. The greater the increase of 2-AG levels, the greater the improvement of depressive (p = 0.031), anxious (p = 0.007) and anhedonia symptoms (p = 0.047).”
- “Our data may indicate that direct stimulation of targeted brain areas can rapidly alleviate depressive complaints via activation of the eCB system.”
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