Intermittent Theta-Burst Stimulation (iTBS) Modulates Abnormal Brain Activity During Emotional Arousal in Adolescent...

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Adolescent depression is increasing, necessitating effective treatments like accelerated Intermittent theta-burst stimulation (iTBS).
• Treatment response to iTBS in adolescent depression is variable.
• Understanding the neural underpinnings of treatment response is crucial for optimizing therapy.

Purpose of the Study:

• To identify brain regions associated with treatment response in adolescent depression undergoing accelerated iTBS.
• To correlate neural signatures with clinical outcomes following accelerated iTBS treatment.
• To investigate the impact of depression on neural processing of emotional arousal using N-fMRI.

Main Methods:

• Naturalistic functional magnetic resonance imaging (N-fMRI) was used to assess brain activity during emotional arousal.
• Fifty-eight adolescents with depression and 29 healthy controls underwent fMRI; 43 patients received accelerated iTBS.
• Statistical analysis involved cluster-based family-wise error correction (p < 0.05) using SPM12.

Main Results:

• Adolescents with depression showed reduced emotion-arousal activation in the left superior frontal gyrus (L-SFG) and left middle frontal gyrus (L-MFG) compared to controls.
• Hamilton Depression Scale scores significantly decreased post-iTBS; L-MFG showed a marginally significant increase in activation.
• Proximity to the L-SFG correlated negatively with Generalized Anxiety Disorder-7 reduction, suggesting a link to treatment response.

Conclusions:

• Abnormal activity in L-SFG and L-MFG may underlie variable iTBS efficacy in adolescent depression.
• L-SFG proximity and L-MFG activation changes show potential as exploratory biomarkers for iTBS mechanisms.
• Further confirmatory research is needed to validate these neuroanatomical targets for adolescent depression treatment.