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Target-Specificity and repeatability in neuro-cardiac-guided TMS for heart-brain coupling.

Zi-Jian Feng1,2,3, Sandra Martin3,4, Ole Numssen5

  • 1TMS center, The Third People's Hospital of Deqing (Deqing Hospital of Hangzhou Normal University), Deqing, 313200, China.

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Summary
This summary is machine-generated.

Heart rate changes after transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC) can indicate effective treatment targets. Specific DLPFC locations and stimulation intensity non-linearly modulated heart-brain coupling (HBC).

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Area of Science:

  • Neuroscience
  • Cardiology
  • Psychiatry

Background:

  • The dorsolateral prefrontal cortex (DLPFC) is a key target for transcranial magnetic stimulation (TMS) in treating major depressive disorder.
  • Therapeutic effects of DLPFC stimulation are linked to its connectivity with the subgenual anterior cingulate cortex.
  • Both regions play a role in autonomic regulation, suggesting heart rate changes could indicate stimulation effectiveness.

Purpose of the Study:

  • To investigate the impact of stimulation intensity and DLPFC target specificity on heart-brain coupling (HBC).
  • To explore the potential of neuro-cardiac guided TMS for identifying optimal stimulation targets for depression treatment.

Main Methods:

  • Utilized neuro-cardiac guided TMS in healthy participants.
  • Employed generalized additive models to analyze nonlinear effects of stimulation intensity and location on HBC.
  • Assessed intra-subject repeatability across sessions using intraclass correlation coefficients.

Main Results:

  • Heart-brain coupling (HBC) was non-linearly modulated by stimulation intensity and DLPFC target location.
  • Greater effects on HBC were observed at F3 lateral and F3 posterior targets compared to sham stimulation.
  • A consistent decrease in heart rate (HR) was found specifically at the F3 lateral target with suprathreshold stimulation.

Conclusions:

  • Heart-brain coupling (HBC) modulation by TMS is specific to the stimulation target and intensity.
  • F3 lateral sites within the DLPFC showed particularly consistent effects on HBC.
  • Findings support using HBC as a physiological marker to optimize individualized TMS protocols for depression.