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Updated: Oct 23, 2025

Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method
Published on: August 2, 2021
Prospective study on resting state functional connectivity in adolescents with major depressive disorder after
Suhyuk Chi1, Minjae Song1, Jong-Ha Lee2
1Department of Psychiatry, Korea University Guro Hospital, Seoul, South Korea.
Abstract:
Recent advances in functional magnetic resonance imaging (fMRI) have resulted in many studies on resting-state functional connectivity (rsFC) in depressed patients. Previous studies have shown alterations between multiple brain areas, such as the prefrontal cortex, anterior cingulate cortex, and basal ganglia, but there are very few prospective studies with a longitudinal design on adolescent depression patients. We therefore investigated the change in positive rsFC in a homogeneous drug-naïve adolescent group after 12 weeks of antidepressant treatment. Functional neuroimaging data were collected and analyzed from 32 patients and 27 healthy controls. Based on previous literature, the amygdala, anterior cingulate cortex (ACC), insula, hippocampus, and dorsolateral prefrontal cortex (DLPFC) were selected as seed regions. Seed-to-voxel analyses were performed between pre- and post-treatment states as well as between the patients and controls at baseline. The positive rsFC between the right DLPFC and the left putamen/right frontal operculum were shown to be higher in patients than in the controls. The positive rsFC between the left DLPFC and left putamen/left lingual gyrus was also higher in the patients than in the controls. The positive rsFC between the right dorsal ACC and the left precentral gyrus had reduced after the 12-week antidepressant treatment. Regions involved in the frontolimbic circuit showed changes in the positive rsFC in the depressed adolescents as compared to in the healthy controls. There were also significant changes in the positive rsFC after 12-weeks of antidepressant treatment. The involved regions were associated with emotional regulation, cognitive functioning, impulse control, and visual processing.
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