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Updated: Oct 15, 2026
Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method
Published on: August 2, 2021
Default mode network mechanisms of trait rumination in treatment-resistant depression and rTMS: evidence from
Stephanie A Chu1, Thomas Earl Valles2, Cole C Citrenbaum2
1Neuroscience Interdepartmental Program, UCLA, Los Angeles, CA, USA; TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Background:
Rumination is a transdiagnostic feature of multiple psychiatric disorders and is a critical risk factor for more severe episodes and poor treatment outcomes in treatment-resistant depression (TRD). Repetitive Transcranial Magnetic Stimulation (rTMS) ameliorates both depressive and ruminative symptoms in TRD. While prior literature has linked rumination to abnormal default mode network (DMN) connectivity, the electrophysiological correlates of rumination in the DMN are not well understood.
Methods:
Resting-state electroencephalography (EEG) data were examined in a cohort of 66 TRD subjects who underwent 30 sessions of rTMS treatment for TRD administered to left dorsolateral prefrontal cortex (DLPFC). We employed source-localization and calculated four metrics of functional connectivity (Amplitude Envelope Correlation [AEC], weighted Phase Lag Index [wPLI], magnitude-squared coherence, and Spectral Correlation Coefficient [SCC]) across five frequency bands within the DMN to identify the neural correlates of rumination in TRD. Correction for multiple comparisons was performed using the Network Based Statistic (NBS).
Results:
Baseline severity of rumination and depression were positively correlated, but AEC alpha band connectivity was positively associated only with baseline rumination severity and not depression. Rumination severity prior to treatment was not associated with any other connectivity metric. Severity of rumination and depression decreased following rTMS treatment, but alpha AEC connectivity did not charge after 30 sessions of rTMS treatment.
Conclusion:
Higher DMN connectivity, as measured by alpha-band AEC, is a stable trait-like neurophysiological marker of rumination that is not significantly affected by rTMS administered to left DLPFC.
