Intermittent theta burst stimulation modulates brain metabolism in treatment-resistant depression patients: Insights...

Treatment-resistant depression remains a major clinical challenge, with many patients unresponsive to standard therapies. Intermittent theta burst stimulation has emerged as an effective treatment for this population, yet the biological basis of its therapeutic effects remains incompletely understood. Neuroimaging suggests widespread dysregulation across brain networks, but the metabolic correlates of treatment response are unclear. [¹⁸F]FDG imaging enables assessment of regional glucose metabolism as a marker of neural activity and its modulation by therapeutic intervention. So, in this study, we tested the hypothesis that regional metabolic alterations may be involved in the clinical response to iTBS.

Twenty-five patients diagnosed with TRD underwent two positron emission tomography (PET) scans: one at baseline and another following the fifth session of iTBS.

Among treatment responders, significant metabolic alterations were observed in the right anterior cingulate cortex (ACC) between baseline and follow-up scans. Across the entire cohort, statistically significant alterations were detected in the bilateral lateral prefrontal cortex and the right ACC.

iTBS was associated with significant metabolic alterations in the bilateral prefrontal cortex and right anterior cingulate cortex. These findings shed light on the regional alterations that appear to be associated with therapeutic effects in TRD.