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Updated: Aug 2, 2025
Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex
Published on: August 17, 2018
Identifying Neurophysiological Markers of Intermittent Theta Burst Stimulation in Treatment-Resistant Depression
Rebecca Strafella1, Davide Momi2, Reza Zomorrodi3
1Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Intermittent theta burst stimulation (iTBS) for depression altered neurophysiological markers, with N100 amplitude decreases linked to treatment response. Higher baseline N100 predicted better outcomes, suggesting TMS-EEG markers may guide treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Technology
Background:
- Intermittent theta burst stimulation (iTBS) is effective for treatment-resistant depression.
- The impact of iTBS on neurophysiological markers is not fully understood.
- Transcranial magnetic stimulation-electroencephalography (TMS-EEG) can assess neurophysiological changes.
Purpose of the Study:
- To investigate the effects of iTBS on TMS-EEG markers (N45 and N100 amplitudes).
- To compare neurophysiological changes between separated and contiguous iTBS schedules.
- To identify TMS-EEG markers differentiating iTBS responders from nonresponders.
Main Methods:
- A randomized trial compared separated and contiguous iTBS schedules for treatment-resistant depression.
- TMS-EEG was performed at baseline and posttreatment over the left dorsolateral prefrontal cortex.
- N45 and N100 amplitudes were analyzed using global mean field analysis.
Main Results:
- N100 amplitude decreased post-iTBS across both schedules.
- Responders showed a significant decrease in N100 amplitude and higher posttreatment N45 amplitude.
- Higher baseline N100 amplitude predicted lower post-iTBS depression scores.
Conclusions:
- iTBS treatment efficacy in depression is associated with changes in neurophysiological markers.
- N100 amplitude changes and baseline levels may predict treatment response.
- TMS-EEG markers hold potential for guiding clinical applications of iTBS.
