TY - JOUR
T1 - Neurophysiological impact of theta burst stimulation followed by cognitive exercise in treatment of youth depression
AU - Dhami, Prabhjot
AU - Lee, Jonathan
AU - Schwartzmann, Benjamin
AU - Knyahnytska, Yuliya
AU - Atluri, Sravya
AU - Christie, Gregory J.
AU - Croarkin, Paul E.
AU - Blumberger, Daniel M.
AU - Daskalakis, Zafiris J.
AU - Moreno, Sylvain
AU - Farzan, Faranak
N1 - Funding Information:
PD was supported by the doctoral award from Canadian Institute of Health Research (CIHR). FF received funding from Michael Smith Foundation for Health Research Scholar Award, the Caskey-Francis and Slaight Family Foundations, CIHR, and Natural Sciences and Engineering Council of Canada (NSERC). PEC was supported by National Institute of Mental Health of the National Institutes of Health under Award Numbers R01MH113700 and R01MH124655 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DMB receives research support from CIHR , NIMH, Brain Canada and the Temerty Family through the CAMH Foundation and the Campbell Research Institute.
Publisher Copyright:
© 2022
PY - 2022/12
Y1 - 2022/12
N2 - Background: Targeting the dorsolateral prefrontal cortex (DLPFC) with repeated sessions of theta-burst stimulation (TBS) is a promising treatment for youth depression. However, it remains unclear whether TBS selectively acts upon inhibitory and/or excitatory measures. Such insight could aid with the development of biomarker driven approaches to delivering TBS in youth with depression. Methods: Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) was used to assess the neurophysiological impact of a 4-week bilateral DLPFC-targeted TBS trial followed by a cognitive exercise for the treatment of depression in youth. In 26 youth with depression (aged 16–24 years old), TMS-evoked potentials (TEPs) were assessed at baseline and after treatment completion from the bilateral DLPFC and inferior parietal lobules (IPL). Results: Following treatment, there were significant changes in TEPs both local and distal to the stimulated treatment sites. The amplitude of the left DLPFC N100 response was significantly reduced. Also, there was a significant association between changes in the right DLPFC N45 response and reduction in depressive and rumination scores. Additionally, the amplitude of the right IPL N100 response was reduced. Moreover, the modulation of the right IPL N100 response was significantly associated with a reduction in depressive scores. Limitations: The primary limitation was the lack of a sham treatment arm. Conclusions: Bilateral DLPFC TBS may exert its therapeutic impact by modulating the neurophysiology of regions and networks both local and distal to the treatment site. Collectively, our findings offer novel insight into the potential therapeutic mechanisms of TBS for the treatment of youth depression.
AB - Background: Targeting the dorsolateral prefrontal cortex (DLPFC) with repeated sessions of theta-burst stimulation (TBS) is a promising treatment for youth depression. However, it remains unclear whether TBS selectively acts upon inhibitory and/or excitatory measures. Such insight could aid with the development of biomarker driven approaches to delivering TBS in youth with depression. Methods: Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) was used to assess the neurophysiological impact of a 4-week bilateral DLPFC-targeted TBS trial followed by a cognitive exercise for the treatment of depression in youth. In 26 youth with depression (aged 16–24 years old), TMS-evoked potentials (TEPs) were assessed at baseline and after treatment completion from the bilateral DLPFC and inferior parietal lobules (IPL). Results: Following treatment, there were significant changes in TEPs both local and distal to the stimulated treatment sites. The amplitude of the left DLPFC N100 response was significantly reduced. Also, there was a significant association between changes in the right DLPFC N45 response and reduction in depressive and rumination scores. Additionally, the amplitude of the right IPL N100 response was reduced. Moreover, the modulation of the right IPL N100 response was significantly associated with a reduction in depressive scores. Limitations: The primary limitation was the lack of a sham treatment arm. Conclusions: Bilateral DLPFC TBS may exert its therapeutic impact by modulating the neurophysiology of regions and networks both local and distal to the treatment site. Collectively, our findings offer novel insight into the potential therapeutic mechanisms of TBS for the treatment of youth depression.
KW - Adolescence
KW - Depression
KW - Electroencephalography
KW - Major Depressive Disorder (MDD)
KW - Theta Burst Stimulation (TBS)
KW - Transcranial Magnetic Stimulation (TMS)
KW - Youth
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U2 - 10.1016/j.jadr.2022.100439
DO - 10.1016/j.jadr.2022.100439
M3 - Article
AN - SCOPUS:85142182072
SN - 0941-9500
VL - 10
JO - Journal of Affective Disorders Reports
JF - Journal of Affective Disorders Reports
M1 - 100439
ER -