BACKGROUND: Neuroimaging studies suggest that the prefrontal cortex (PFC) is involved in the pathophysiology of major depression. Repetitive transcranial magnetic stimulation (rTMS) as an antidepressant intervention has increasingly been investigated in the last two decades. In this study metabolic changes within PFC of severely depressed patients before and after rTMS were evaluated by proton magnetic resonance spectroscopy (1H-MRS). METHOD:Thirty-four young depressed patients with treatment-resistant unipolar depression were enrolled in a double-blind, randomized study active ((n=19) vs. sham(n=15)), and the PFC was investigated before and after high-frequency (15 Hz) rTMS using 3-tesla proton magnetic resonance spectroscopy. Response was defined as a 50% reduction of the Hamilton depression rating scale. The results were compared with 28 age- and gender-matched healthy controls. RESULTS: In depressive patients a significant reduction in myo-inositol (m-Ino) was observed pre-rTMS (p<0.001). After successful treatment, m-Ino increased significantly in left PFC and the levels no longer differed from those of age-matched controls. In addition to a positive correlation between clinical improvement and an increment in m-Ino ratio, a correlation between clinical improvement and early age onset was observed. CONCLUSIONS: Our results support the notion that major depressive disorder is accompanied by state-dependent metabolic alterations, especially in myo-inositol metabolism, which can be partly reversed by successful rTMS.
RCT Entities:
BACKGROUND: Neuroimaging studies suggest that the prefrontal cortex (PFC) is involved in the pathophysiology of major depression. Repetitive transcranial magnetic stimulation (rTMS) as an antidepressant intervention has increasingly been investigated in the last two decades. In this study metabolic changes within PFC of severely depressedpatients before and after rTMS were evaluated by proton magnetic resonance spectroscopy (1H-MRS). METHOD: Thirty-four young depressedpatients with treatment-resistant unipolar depression were enrolled in a double-blind, randomized study active ((n=19) vs. sham(n=15)), and the PFC was investigated before and after high-frequency (15 Hz) rTMS using 3-tesla proton magnetic resonance spectroscopy. Response was defined as a 50% reduction of the Hamilton depression rating scale. The results were compared with 28 age- and gender-matched healthy controls. RESULTS: In depressivepatients a significant reduction in myo-inositol (m-Ino) was observed pre-rTMS (p<0.001). After successful treatment, m-Ino increased significantly in left PFC and the levels no longer differed from those of age-matched controls. In addition to a positive correlation between clinical improvement and an increment in m-Ino ratio, a correlation between clinical improvement and early age onset was observed. CONCLUSIONS: Our results support the notion that major depressive disorder is accompanied by state-dependent metabolic alterations, especially in myo-inositol metabolism, which can be partly reversed by successful rTMS.
Authors: Joshua Chiappelli; Laura M Rowland; S Andrea Wijtenburg; Florian Muellerklein; Malle Tagamets; Robert P McMahon; Frank Gaston; Peter Kochunov; L Elliot Hong Journal: Neuropsychopharmacology Date: 2015-02-27 Impact factor: 7.853
Authors: Laura E Leggett; Lesley J J Soril; Stephanie Coward; Diane L Lorenzetti; Gail MacKean; Fiona M Clement Journal: Prim Care Companion CNS Disord Date: 2015-11-05
Authors: Iska Moxon-Emre; Paul E Croarkin; Zafiris J Daskalakis; Daniel M Blumberger; Rachael E Lyon; Hideaki Tani; Peter Truong; Meng-Chuan Lai; Pushpal Desarkar; Napapon Sailasuta; Peter Szatmari; Stephanie H Ameis Journal: Brain Sci Date: 2022-06-15
Authors: Paul E Croarkin; Paul A Nakonezny; Christopher A Wall; Lauren L Murphy; Shirlene M Sampson; Mark A Frye; John D Port Journal: Psychiatry Res Neuroimaging Date: 2015-11-27 Impact factor: 2.376
Authors: Thiago M Fidalgo; J Leon Morales-Quezada; Guilherme S C Muzy; Noelle M Chiavetta; Mariana E Mendonca; Marcus V B Santana; Oscar F Goncalves; Andre R Brunoni; Felipe Fregni Journal: J ECT Date: 2014-03 Impact factor: 3.635