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Related Experiment Video

Updated: Dec 12, 2025

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
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Parcel-guided rTMS for depression.

M Moreno-Ortega1,2, A Kangarlu3, S Lee4

  • 1Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA. mm4355@cumc.columbia.edu.

Translational Psychiatry
|August 14, 2020
PubMed
Summary
This summary is machine-generated.

MRI-guided transcranial magnetic stimulation (TMS) shows promise for treatment-resistant depression (TRD) when standard TMS fails. This novel approach improved outcomes and altered brain connectivity in patients who did not respond to previous treatments.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Imaging

Background:

  • Transcranial magnetic stimulation (TMS) is approved for treatment-resistant depression (TRD).
  • Current TMS targeting methods have limited success rates.
  • Previous TMS treatments failed in the patient cohort studied.

Purpose of the Study:

  • To assess the clinical feasibility of MRI-guided TMS using surface-based parcellation in TRD patients.
  • To compare neurobiological mechanisms and clinical outcomes of MRI-guided TMS versus standard TMS.
  • To investigate the efficacy of parcel-guided TMS (pgTMS) in patients refractory to standard TMS.

Main Methods:

  • Utilized parcel-guided TMS (pgTMS) to target the left dorsolateral prefrontal cortex parcel 46.
  • Assessed resting-state functional connectivity (rsfc) between parcel 46 and default mode/visual networks.
  • Compared pgTMS with standard TMS (sdTMS) in patients with a history of failed sdTMS.

Main Results:

  • All 10 patients who failed sdTMS responded to pgTMS.
  • Significant differences in rsfc alterations between frontal, default mode, and visual networks were observed over time.
  • Symptom improvements correlated with rsfc changes within each treatment group.

Conclusions:

  • Parcel-guided TMS (pgTMS) is feasible in a clinical setting for TRD.
  • pgTMS demonstrates potential for patients unresponsive to standard TMS.
  • Further research via prospective, double-blind studies comparing pgTMS and sdTMS is warranted.