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Updated: Feb 28, 2026
Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method
Published on: August 2, 2021
The Relationship Between Emotion Processing Assessed by an Affect Rating Task and Depression Symptoms Following the
Ruiqin Chen1,2, Zerun Dong1,3, Ruijie Geng4
1Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China.
Background:
Emotion processing is critical in the neuropathology of major depressive disorder (MDD), while its relationship with clinical treatment remains unclear. This study aims to indicate the associations between emotion processing and treatment effects following a sequential dual-site accelerated repetitive transcranial magnetic stimulation (rTMS) protocol.
Methods:
MDD patients were recruited to receive rTMS treatment with four sessions per day for four consecutive days, with stimulation sequentially delivered to the left dorsolateral prefrontal cortex (dlPFC) and the dorsomedial prefrontal cortex (dmPFC). Symptoms were assessed at baseline, end of treatment, and week 4 using the Montgomery-Åsberg Depression Rating Scale (MADRS), Snaith-Hamilton Pleasure Scale (SHAPS), and Fatigue Severity Scale (FSS). Emotional valence and arousal were evaluated with the Affect Rating Task (ART).
Results:
A total of 51 participants completed the clinical assessments and ART, with two excluded due to missing baseline data in the SHAPS and FSS. The linear mixed-effects models revealed significant improvement in depressive (p < 0.001, d = -0.343) and fatigue symptoms (p = 0.010, d = -0.572) following rTMS treatment. Neutral valence was correlated with MADRS scores at baseline (R2 = 0.096, p = 0.027). In addition, changes in arousal for positive images (p = 0.047, adjusted R2 = 0.097) and neutral images (p = 0.019, adjusted R2 = 0.160) at treatment end were significantly correlated with MADRS improvement at week 4.
Conclusions:
Our study highlights the association between changes in emotional arousal and improvement in MDD following accelerated dlPFC-dmPFC dual-site rTMS treatment.
