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Parcel-guided rTMS for depression
Transcranial magnetic stimulation (TMS) is an approved intervention for treatment-resistant depression (TRD), but current targeting approaches are only partially successful. Our objectives were (1) to examine the feasibility of MRI-guided TMS in the clinical setting using a recently published surfac...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7423622/ https://www.ncbi.nlm.nih.gov/pubmed/32788580 http://dx.doi.org/10.1038/s41398-020-00970-8 |
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author | Moreno-Ortega, M. Kangarlu, A. Lee, S. Perera, T. Kangarlu, J. Palomo, T. Glasser, M. F. Javitt, D. C. |
author_facet | Moreno-Ortega, M. Kangarlu, A. Lee, S. Perera, T. Kangarlu, J. Palomo, T. Glasser, M. F. Javitt, D. C. |
author_sort | Moreno-Ortega, M. |
collection | PubMed |
description | Transcranial magnetic stimulation (TMS) is an approved intervention for treatment-resistant depression (TRD), but current targeting approaches are only partially successful. Our objectives were (1) to examine the feasibility of MRI-guided TMS in the clinical setting using a recently published surface-based, multimodal parcellation in patients with TRD who failed standard TMS (sdTMS); (2) to examine the neurobiological mechanisms and clinical outcomes underlying MRI-guided TMS compared to that of sdTMS. We used parcel-guided TMS (pgTMS) to target the left dorsolateral prefrontal cortex parcel 46. Resting-state functional connectivity (rsfc) was assessed between parcel 46 and predefined nodes within the default mode and visual networks, following both pgTMS and sdTMS. All patients (n = 10) who had previously failed sdTMS responded to pgTMS. Alterations in rsfc between frontal, default mode, and visual networks differed significantly over time between groups. Improvements in symptoms correlated with alterations in rsfc within each treatment group. The outcome of our study supports the feasibility of pgTMS within the clinical setting. Future prospective, double-blind studies of pgTMS vs. sdTMS appear warranted. |
format | Online Article Text |
id | pubmed-7423622 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-74236222020-08-18 Parcel-guided rTMS for depression Moreno-Ortega, M. Kangarlu, A. Lee, S. Perera, T. Kangarlu, J. Palomo, T. Glasser, M. F. Javitt, D. C. Transl Psychiatry Article Transcranial magnetic stimulation (TMS) is an approved intervention for treatment-resistant depression (TRD), but current targeting approaches are only partially successful. Our objectives were (1) to examine the feasibility of MRI-guided TMS in the clinical setting using a recently published surface-based, multimodal parcellation in patients with TRD who failed standard TMS (sdTMS); (2) to examine the neurobiological mechanisms and clinical outcomes underlying MRI-guided TMS compared to that of sdTMS. We used parcel-guided TMS (pgTMS) to target the left dorsolateral prefrontal cortex parcel 46. Resting-state functional connectivity (rsfc) was assessed between parcel 46 and predefined nodes within the default mode and visual networks, following both pgTMS and sdTMS. All patients (n = 10) who had previously failed sdTMS responded to pgTMS. Alterations in rsfc between frontal, default mode, and visual networks differed significantly over time between groups. Improvements in symptoms correlated with alterations in rsfc within each treatment group. The outcome of our study supports the feasibility of pgTMS within the clinical setting. Future prospective, double-blind studies of pgTMS vs. sdTMS appear warranted. Nature Publishing Group UK 2020-08-12 /pmc/articles/PMC7423622/ /pubmed/32788580 http://dx.doi.org/10.1038/s41398-020-00970-8 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Moreno-Ortega, M. Kangarlu, A. Lee, S. Perera, T. Kangarlu, J. Palomo, T. Glasser, M. F. Javitt, D. C. Parcel-guided rTMS for depression |
title | Parcel-guided rTMS for depression |
title_full | Parcel-guided rTMS for depression |
title_fullStr | Parcel-guided rTMS for depression |
title_full_unstemmed | Parcel-guided rTMS for depression |
title_short | Parcel-guided rTMS for depression |
title_sort | parcel-guided rtms for depression |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7423622/ https://www.ncbi.nlm.nih.gov/pubmed/32788580 http://dx.doi.org/10.1038/s41398-020-00970-8 |
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