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Related Concept Videos

Brain Imaging01:14

Brain Imaging

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Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans),  magnetic resonance imaging (MRI),  functional magnetic resonance imaging (fMRI), and Transcranial Magnetic...
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Related Experiment Video

Updated: Aug 8, 2025

Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method
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Functional Connectivity Mapping for rTMS Target Selection in Depression.

Immanuel G Elbau1, Charles J Lynch1, Jonathan Downar1

  • 1Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis).

The American Journal of Psychiatry
|March 1, 2023
PubMed
Summary
This summary is machine-generated.

Individualizing repetitive transcranial magnetic stimulation (rTMS) using subgenual anterior cingulate cortex (sgACC) functional connectivity shows a weak but real effect on depression treatment outcomes, particularly in patients with specific respiratory patterns.

Keywords:
Functional connectivityMajor depressive disorderNeuroimagingNeurostimulationSubgenual anterior cingulate cortexTranscranial magnetic stimulation

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Imaging

Background:

  • Repetitive transcranial magnetic stimulation (rTMS) is a treatment for major depressive disorder.
  • Individualizing rTMS targets using functional connectivity, specifically with the subgenual anterior cingulate cortex (sgACC), is an emerging strategy.
  • The clinical utility of sgACC functional connectivity for guiding rTMS remains uncertain due to inconsistent findings.

Purpose of the Study:

  • To investigate the relationship between sgACC functional connectivity and rTMS treatment outcomes in major depression.
  • To assess the reliability of sgACC functional connectivity estimation.
  • To identify factors contributing to heterogeneity in treatment response.

Main Methods:

  • Validated estimation of sgACC functional connectivity using functional MRI data.
  • Applied electric field modeling to link sgACC-StimFC to clinical improvement.
  • Analyzed data from 295 patients with major depression undergoing rTMS.

Main Results:

  • sgACC-StimFC showed a weak but robust correlation with treatment response (r=-0.16) when the stimulation site was accurately determined.
  • This association was significantly stronger in patients exhibiting specific respiratory-related global signal fluctuations (r=-0.49).
  • Individual differences in sgACC-StimFC explained approximately 3% of the variance in treatment outcomes.

Conclusions:

  • sgACC functional connectivity has a small but significant effect on rTMS treatment outcomes for depression.
  • Existing sgACC-based targeting protocols may have limited predictive power due to the small effect size.
  • Incorporating additional functional connectivity measures could enhance predictive models for rTMS response.