An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets
Abstract Introduction Data‐driven approaches to transcranial magnetic stimulation (TMS) might yield more consistent and symptom‐specific results based on individualized functional connectivity analyses compared to previous traditional approaches due to more precise targeting. We provide a proof of c...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-05-01
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| Series: | Brain and Behavior |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/brb3.2914 |
| _version_ | 1797828910151368704 |
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| author | Isabella M. Young Hugh M. Taylor Peter J. Nicholas Alana Mackenzie Onur Tanglay Nicholas B. Dadario Karol Osipowicz Ethan Davis Stephane Doyen Charles Teo Michael E. Sughrue |
| author_facet | Isabella M. Young Hugh M. Taylor Peter J. Nicholas Alana Mackenzie Onur Tanglay Nicholas B. Dadario Karol Osipowicz Ethan Davis Stephane Doyen Charles Teo Michael E. Sughrue |
| author_sort | Isabella M. Young |
| collection | DOAJ |
| description | Abstract Introduction Data‐driven approaches to transcranial magnetic stimulation (TMS) might yield more consistent and symptom‐specific results based on individualized functional connectivity analyses compared to previous traditional approaches due to more precise targeting. We provide a proof of concept for an agile target selection paradigm based on using connectomic methods that can be used to detect patient‐specific abnormal functional connectivity, guide treatment aimed at the most abnormal regions, and optimize the rapid development of new hypotheses for future study. Methods We used the resting‐state functional MRI data of 28 patients with medically refractory generalized anxiety disorder to perform agile target selection based on abnormal functional connectivity patterns between the Default Mode Network (DMN) and Central Executive Network (CEN). The most abnormal areas of connectivity within these regions were selected for subsequent targeted TMS treatment by a machine learning based on an anomalous functional connectivity detection matrix. Areas with mostly hyperconnectivity were stimulated with continuous theta burst stimulation and the converse with intermittent theta burst stimulation. An image‐guided accelerated theta burst stimulation paradigm was used for treatment. Results Areas 8Av and PGs demonstrated consistent abnormalities, particularly in the left hemisphere. Significant improvements were demonstrated in anxiety symptoms, and few, minor complications were reported (fatigue (n = 2) and headache (n = 1)). Conclusions Our study suggests that a left‐lateralized DMN is likely the primary functional network disturbed in anxiety‐related disorders, which can be improved by identifying and targeting abnormal regions with a rapid, data‐driven, agile aTBS treatment on an individualized basis. |
| first_indexed | 2024-04-09T13:11:58Z |
| format | Article |
| id | doaj.art-08dea16b96f2412f943ffcd76157f711 |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-04-09T13:11:58Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-08dea16b96f2412f943ffcd76157f7112023-05-12T06:32:34ZengWileyBrain and Behavior2162-32792023-05-01135n/an/a10.1002/brb3.2914An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targetsIsabella M. Young0Hugh M. Taylor1Peter J. Nicholas2Alana Mackenzie3Onur Tanglay4Nicholas B. Dadario5Karol Osipowicz6Ethan Davis7Stephane Doyen8Charles Teo9Michael E. Sughrue10Omniscient Neurotechnology Sydney New South Wales AustraliaOmniscient Neurotechnology Sydney New South Wales AustraliaOmniscient Neurotechnology Sydney New South Wales AustraliaOmniscient Neurotechnology Sydney New South Wales AustraliaOmniscient Neurotechnology Sydney New South Wales AustraliaRutgers Robert Wood Johnson School of Medicine New Brunswick New JerseyOmniscient Neurotechnology Sydney New South Wales AustraliaCingulum Health Sydney New South Wales AustraliaOmniscient Neurotechnology Sydney New South Wales AustraliaCingulum Health Sydney New South Wales AustraliaOmniscient Neurotechnology Sydney New South Wales AustraliaAbstract Introduction Data‐driven approaches to transcranial magnetic stimulation (TMS) might yield more consistent and symptom‐specific results based on individualized functional connectivity analyses compared to previous traditional approaches due to more precise targeting. We provide a proof of concept for an agile target selection paradigm based on using connectomic methods that can be used to detect patient‐specific abnormal functional connectivity, guide treatment aimed at the most abnormal regions, and optimize the rapid development of new hypotheses for future study. Methods We used the resting‐state functional MRI data of 28 patients with medically refractory generalized anxiety disorder to perform agile target selection based on abnormal functional connectivity patterns between the Default Mode Network (DMN) and Central Executive Network (CEN). The most abnormal areas of connectivity within these regions were selected for subsequent targeted TMS treatment by a machine learning based on an anomalous functional connectivity detection matrix. Areas with mostly hyperconnectivity were stimulated with continuous theta burst stimulation and the converse with intermittent theta burst stimulation. An image‐guided accelerated theta burst stimulation paradigm was used for treatment. Results Areas 8Av and PGs demonstrated consistent abnormalities, particularly in the left hemisphere. Significant improvements were demonstrated in anxiety symptoms, and few, minor complications were reported (fatigue (n = 2) and headache (n = 1)). Conclusions Our study suggests that a left‐lateralized DMN is likely the primary functional network disturbed in anxiety‐related disorders, which can be improved by identifying and targeting abnormal regions with a rapid, data‐driven, agile aTBS treatment on an individualized basis.https://doi.org/10.1002/brb3.2914anxietybrain stimulationrepetitive transcranial magnetic stimulationtreatment |
| spellingShingle | Isabella M. Young Hugh M. Taylor Peter J. Nicholas Alana Mackenzie Onur Tanglay Nicholas B. Dadario Karol Osipowicz Ethan Davis Stephane Doyen Charles Teo Michael E. Sughrue An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets Brain and Behavior anxiety brain stimulation repetitive transcranial magnetic stimulation treatment |
| title | An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets |
| title_full | An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets |
| title_fullStr | An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets |
| title_full_unstemmed | An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets |
| title_short | An agile, data‐driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets |
| title_sort | agile data driven approach for target selection in rtms therapy for anxiety symptoms proof of concept and preliminary data for two novel targets |
| topic | anxiety brain stimulation repetitive transcranial magnetic stimulation treatment |
| url | https://doi.org/10.1002/brb3.2914 |
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