Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder

ObjectiveRepetitive transcranial magnetic stimulation (rTMS) can effectively improve depression symptoms in patients with major depressive disorder (MDD); however, its mechanism of action remains obscure. This study explored the neuralimaging mechanisms of rTMS in improving depression symptoms in pa...

Full description

Bibliographic Details
Main Authors: Muzhen Guan, Zhongheng Wang, Yanru Shi, Yuanjun Xie, Zhujing Ma, Zirong Liu, Junchang Liu, Xinyu Gao, Qingrong Tan, Huaning Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-03-01
Series:Frontiers in Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnins.2022.855483/full
_version_ 1818137488341860352
author Muzhen Guan
Muzhen Guan
Zhongheng Wang
Yanru Shi
Yuanjun Xie
Zhujing Ma
Zirong Liu
Junchang Liu
Xinyu Gao
Qingrong Tan
Huaning Wang
author_facet Muzhen Guan
Muzhen Guan
Zhongheng Wang
Yanru Shi
Yuanjun Xie
Zhujing Ma
Zirong Liu
Junchang Liu
Xinyu Gao
Qingrong Tan
Huaning Wang
author_sort Muzhen Guan
collection DOAJ
description ObjectiveRepetitive transcranial magnetic stimulation (rTMS) can effectively improve depression symptoms in patients with major depressive disorder (MDD); however, its mechanism of action remains obscure. This study explored the neuralimaging mechanisms of rTMS in improving depression symptoms in patients with MDD.MethodsIn this study, MDD patients with first-episode, drug-naive (n = 29) and healthy controls (n = 33) were enrolled. Depression symptoms before and after rTMS treatment were assessed using the Hamilton Depression Rating Scale (HAMD-17). Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected both before and after the treatment. Changes in the brain function after the treatment were compared using the following two indices: the amplitude of the low-frequency fluctuation (ALFF) and regional homogeneity (ReHo), which are sensitive for evaluating spontaneous neuronal activity. The brain region with synchronous changes was selected as the seed point, and the differences in the causal connectivity between the seed point and whole brain before and after rTMS treatment were investigated via Granger causality analysis (GCA).ResultsBefore treatment, patients with MDD had significantly lower ALFF in the left superior frontal gyrus (p < 0.01), higher ALFF in the left middle frontal gyrus and left precuneus (p < 0.01), and lower ReHo in the left middle frontal and left middle occipital gyri (p < 0.01) than the values observed in healthy controls. After the rTMS treatment, the ALFF was significantly increased in the left superior frontal gyrus (p < 0.01) and decreased in the left middle frontal gyrus and left precuneus (p < 0.01). Furthermore, ReHo was significantly increased in the left middle frontal and left middle occipital gyri (p < 0.01) in patients with MDD. Before treatment, GCA using the left middle frontal gyrus (the brain region with synchronous changes) as the seed point revealed a weak bidirectional causal connectivity between the middle and superior frontal gyri as well as a weak causal connectivity from the inferior temporal to the middle frontal gyri. After treatment, these causal connectivities were strengthened. Moreover, the causal connectivity from the inferior temporal gyrus to the middle frontal gyri negatively correlated with the total HAMD-17 score (r = −0.443, p = 0.021).ConclusionrTMS treatment not only improves the local neural activity in the middle frontal gyrus, superior frontal gyrus, and precuneus but also strengthens the bidirectional causal connectivity between the middle and superior frontal gyri and the causal connectivity from the inferior temporal to the middle frontal gyri. Changes in these neuroimaging indices may represent the neural mechanisms underlying rTMS treatment in MDD.Clinical Trial RegistrationThis study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1800019761).
first_indexed 2024-12-11T09:57:06Z
format Article
id doaj.art-8344b8ad11f346729b3442e4f5759c6a
institution Directory Open Access Journal
issn 1662-453X
language English
last_indexed 2024-12-11T09:57:06Z
publishDate 2022-03-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neuroscience
spelling doaj.art-8344b8ad11f346729b3442e4f5759c6a2022-12-22T01:12:15ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-03-011610.3389/fnins.2022.855483855483Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive DisorderMuzhen Guan0Muzhen Guan1Zhongheng Wang2Yanru Shi3Yuanjun Xie4Zhujing Ma5Zirong Liu6Junchang Liu7Xinyu Gao8Qingrong Tan9Huaning Wang10Department of Mental Health, Xi’an Medical University, Xi’an, ChinaDeptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDeptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDeptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDeptartment of Psychology, Air Force Medical University, Xi’an, ChinaDeptartment of Psychiatry, Yulin Fifth Hospital, Yuling, ChinaDeptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDeptartment of Psychology, Air Force Medical University, Xi’an, ChinaDeptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDeptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, ChinaObjectiveRepetitive transcranial magnetic stimulation (rTMS) can effectively improve depression symptoms in patients with major depressive disorder (MDD); however, its mechanism of action remains obscure. This study explored the neuralimaging mechanisms of rTMS in improving depression symptoms in patients with MDD.MethodsIn this study, MDD patients with first-episode, drug-naive (n = 29) and healthy controls (n = 33) were enrolled. Depression symptoms before and after rTMS treatment were assessed using the Hamilton Depression Rating Scale (HAMD-17). Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected both before and after the treatment. Changes in the brain function after the treatment were compared using the following two indices: the amplitude of the low-frequency fluctuation (ALFF) and regional homogeneity (ReHo), which are sensitive for evaluating spontaneous neuronal activity. The brain region with synchronous changes was selected as the seed point, and the differences in the causal connectivity between the seed point and whole brain before and after rTMS treatment were investigated via Granger causality analysis (GCA).ResultsBefore treatment, patients with MDD had significantly lower ALFF in the left superior frontal gyrus (p < 0.01), higher ALFF in the left middle frontal gyrus and left precuneus (p < 0.01), and lower ReHo in the left middle frontal and left middle occipital gyri (p < 0.01) than the values observed in healthy controls. After the rTMS treatment, the ALFF was significantly increased in the left superior frontal gyrus (p < 0.01) and decreased in the left middle frontal gyrus and left precuneus (p < 0.01). Furthermore, ReHo was significantly increased in the left middle frontal and left middle occipital gyri (p < 0.01) in patients with MDD. Before treatment, GCA using the left middle frontal gyrus (the brain region with synchronous changes) as the seed point revealed a weak bidirectional causal connectivity between the middle and superior frontal gyri as well as a weak causal connectivity from the inferior temporal to the middle frontal gyri. After treatment, these causal connectivities were strengthened. Moreover, the causal connectivity from the inferior temporal gyrus to the middle frontal gyri negatively correlated with the total HAMD-17 score (r = −0.443, p = 0.021).ConclusionrTMS treatment not only improves the local neural activity in the middle frontal gyrus, superior frontal gyrus, and precuneus but also strengthens the bidirectional causal connectivity between the middle and superior frontal gyri and the causal connectivity from the inferior temporal to the middle frontal gyri. Changes in these neuroimaging indices may represent the neural mechanisms underlying rTMS treatment in MDD.Clinical Trial RegistrationThis study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1800019761).https://www.frontiersin.org/articles/10.3389/fnins.2022.855483/fullmajor depressive disorderamplitude of the low-frequency fluctuationregional homogeneityGranger causality analysis (GCA)repetitive transcranial magnetic stimulation
spellingShingle Muzhen Guan
Muzhen Guan
Zhongheng Wang
Yanru Shi
Yuanjun Xie
Zhujing Ma
Zirong Liu
Junchang Liu
Xinyu Gao
Qingrong Tan
Huaning Wang
Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder
Frontiers in Neuroscience
major depressive disorder
amplitude of the low-frequency fluctuation
regional homogeneity
Granger causality analysis (GCA)
repetitive transcranial magnetic stimulation
title Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder
title_full Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder
title_fullStr Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder
title_full_unstemmed Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder
title_short Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder
title_sort altered brain function and causal connectivity induced by repetitive transcranial magnetic stimulation treatment for major depressive disorder
topic major depressive disorder
amplitude of the low-frequency fluctuation
regional homogeneity
Granger causality analysis (GCA)
repetitive transcranial magnetic stimulation
url https://www.frontiersin.org/articles/10.3389/fnins.2022.855483/full
work_keys_str_mv AT muzhenguan alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT muzhenguan alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT zhonghengwang alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT yanrushi alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT yuanjunxie alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT zhujingma alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT zirongliu alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT junchangliu alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT xinyugao alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT qingrongtan alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder
AT huaningwang alteredbrainfunctionandcausalconnectivityinducedbyrepetitivetranscranialmagneticstimulationtreatmentformajordepressivedisorder