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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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Author Spotlight: Therapeutic Benefit of Closed-Loop Deep Brain Stimulation in Depression Treatment
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Non-Invasively Targeting, Probing, and Modulating a Deep Brain Circuit for Depression Alleviation.

Desmond J Oathes1,2, Romain J-P Duprat1, Justin Reber1

  • 1Department of Psychiatry, Center for Neuromodulation in Depression and Stress, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

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Summary
This summary is machine-generated.

Repetitive transcranial magnetic stimulation (rTMS) effectively treats depression by engaging brain circuits. This study shows that TMS-evoked responses in the subgenual anterior cingulate cortex (sgACC) predict clinical improvement in depression patients.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Imaging

Background:

  • Repetitive transcranial magnetic stimulation (rTMS) is a promising depression treatment.
  • Focus has been on modulating the subgenual anterior cingulate cortex (sgACC).
  • No prior studies linked sgACC TMS-evoked responses to clinical outcomes.

Purpose of the Study:

  • To demonstrate sgACC circuit engagement using TMS-evoked responses.
  • To investigate the relationship between sgACC TMS-evoked responses and clinical effects of rTMS for depression.
  • To establish causal evidence of sgACC engagement and its clinical relevance.

Main Methods:

  • Used interleaved single-pulse TMS/fMRI in 36 unmedicated depressed patients.
  • Identified sgACC-connected cortical targets using rs-fMRI.
  • Assessed TMS-evoked fMRI BOLD responses in sgACC before and after a 3-day iTBS rTMS intervention.

Main Results:

  • Pre-intervention sgACC TMS-evoked response magnitude predicted depression improvement.
  • More negative evoked responses correlated with greater clinical improvement.
  • Post-intervention changes in evoked responses also associated with depression improvement, specific to the targeted pathway.

Conclusions:

  • Demonstrated causal evidence of sgACC engagement via TMS/fMRI.
  • Showed the clinical relevance of engaging and modulating the prefrontal-sgACC circuit.
  • TMS-evoked responses in sgACC serve as a prognostic biomarker for rTMS treatment in depression.