Loading…

Identifying Neurophysiological Markers of Intermittent Theta Burst Stimulation in Treatment-Resistant Depression Using Transcranial Magnetic Stimulation–Electroencephalography

Intermittent theta burst stimulation (iTBS) targeting the left dorsolateral prefrontal cortex is effective for treatment-resistant depression, but the effects of iTBS on neurophysiological markers remain unclear. Here, we indexed transcranial magnetic stimulation–electroencephalography (TMS-EEG) mar...

Full description

Saved in:
Bibliographic Details
Published in:Biological psychiatry (1969) 2023-09, Vol.94 (6), p.454-465
Main Authors: Strafella, Rebecca, Momi, Davide, Zomorrodi, Reza, Lissemore, Jennifer, Noda, Yoshihiro, Chen, Robert, Rajji, Tarek K., Griffiths, John D., Vila-Rodriguez, Fidel, Downar, Jonathan, Daskalakis, Zafiris J., Blumberger, Daniel M., Voineskos, Daphne
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Intermittent theta burst stimulation (iTBS) targeting the left dorsolateral prefrontal cortex is effective for treatment-resistant depression, but the effects of iTBS on neurophysiological markers remain unclear. Here, we indexed transcranial magnetic stimulation–electroencephalography (TMS-EEG) markers, specifically, the N45 and N100 amplitudes, at baseline and post-iTBS, comparing separated and contiguous iTBS schedules. TMS-EEG markers were also compared between iTBS responders and nonresponders. TMS-EEG was analyzed from a triple-blind 1:1 randomized trial for treatment-resistant depression, comparing a separated (54-minute interval) and contiguous (0-minute interval) schedule of 2 × 600-pulse iTBS for 30 treatments. Participants underwent TMS-EEG over the left dorsolateral prefrontal cortex at baseline and posttreatment. One hundred fourteen participants had usable TMS-EEG at baseline, and 98 at posttreatment. TMS-evoked potential components (N45, N100) were examined via global mean field analysis. The N100 amplitude decreased from baseline to posttreatment, regardless of the treatment group (F1,106 = 5.20, p = .02). There were no changes in N45 amplitude in either treatment group. In responders, the N100 amplitude decreased after iTBS (F1,102 = 11.30, p = .001, pcorrected = .0004). Responders showed higher posttreatment N45 amplitude than nonresponders (F1,94 = 4.11, p = .045, pcorrected = .016). Higher baseline N100 amplitude predicted lower post-iTBS depression scores (F4,106 = 6.28, p = .00014). These results provide further evidence for an association between the neurophysiological effects of iTBS and treatment efficacy in treatment-resistant depression. Future studies are needed to test the predictive potential for clinical applications of TMS-EEG markers.
ISSN:0006-3223
1873-2402
DOI:10.1016/j.biopsych.2023.04.011