Multimodal Neuroimaging in the Prediction of Deep TMS Response in OCD

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Brain morphological biomarkers are crucial for understanding treatment response in obsessive-compulsive disorder (OCD).
• Multimodal neuroimaging offers comprehensive insights into neural processes and structures for OCD research.
• Identifying predictors of deep Transcranial Magnetic Stimulation (TMS) response is vital for personalized treatment.

Purpose of the Study:

• To compare electrophysiological and brain morphological differences between deep TMS responders and non-responders in OCD patients.
• To evaluate the superiority of multimodal neuroimaging over unimodal approaches in predicting deep TMS treatment response.

Main Methods:

• Thirty-two OCD patients undergoing deep TMS were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
• Patients were categorized as responders (≥50% Y-BOCS reduction) or non-responders.
• Baseline resting-state quantitative electroencephalography (qEEG) and magnetic resonance imaging (MRI) data were analyzed using t-tests and logistic regression.

Main Results:

• Deep TMS responders exhibited increased Alpha-2 power in the left temporal area compared to non-responders.
• Responders also showed increased volume in the left temporal pole, entorhinal area, and parahippocampal gyrus.
• A logistic regression model incorporating both qEEG and MRI markers demonstrated superior prediction performance for treatment response.

Conclusions:

• Specific functional (qEEG Alpha-2 power) and structural (temporal lobe volumes) neuroimaging markers differentiate deep TMS responders from non-responders in OCD.
• Multimodal neuroimaging integrating qEEG and MRI is more effective than unimodal techniques for predicting deep TMS treatment success in OCD.
• These findings contribute novel biomarkers for understanding and predicting therapeutic outcomes in obsessive-compulsive disorder.