Aaron D Boes1, Brandt D Uitermarkt2, Fatimah M Albazron2, Martin J Lan3, Conor Liston4, Alvaro Pascual-Leone5, Marc J Dubin6, Michael D Fox7. 1. Neuroimaging & Noninvasive Brain Stimulation Laboratory, Departments of Pediatrics, Neurology & Psychiatry, W 278 General Hospital, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. Electronic address: aaron-boes@uiowa.edu. 2. Neuroimaging & Noninvasive Brain Stimulation Laboratory, Departments of Pediatrics, Neurology & Psychiatry, W 278 General Hospital, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. 3. Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Dr., Unit 42, New York, NY 10032, USA. 4. Department of Psychiatry, Weill Cornell Medical College, 525 East 68th St, New York, NY 10065, USA. 5. Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA. 6. Department of Psychiatry, Weill Cornell Medical College, 525 East 68th St, New York, NY 10065, USA; Feil Family Mind and Brain Institute, Weill Cornell Medical College, New York, NY 10065, USA. 7. Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA; Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02214, USA.
Abstract
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for medication-refractory major depression, yet the mechanisms of action for this intervention are poorly understood. Here we investigate cerebral cortex thickness as a possible biomarker of rTMS treatment response. METHODS: Longitudinal change in cortical thickness is evaluated relative to clinical outcomes across 48 participants in 2 cohorts undergoing left dorsolateral prefrontal cortex rTMS as a treatment for depression. RESULTS: Our results reveal changes in thickness in a region of the left rostral anterior cingulate cortex that correlate with clinical response, with this region becoming thicker in patients who respond favorably to rTMS and thinner in patients with a less favorable response. Moreover, the baseline cortical thickness in this region correlates with rTMS treatment response - those patients with thinner cortex before treatment tended to have the most clinical improvement. CONCLUSIONS: This study is the first analysis of longitudinal cortical thickness change with rTMS as a treatment for depression with similar results across two cohorts. These results support further investigation into the use of structural MRI as a possible biomarker of rTMS treatment response.
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for medication-refractory major depression, yet the mechanisms of action for this intervention are poorly understood. Here we investigate cerebral cortex thickness as a possible biomarker of rTMS treatment response. METHODS: Longitudinal change in cortical thickness is evaluated relative to clinical outcomes across 48 participants in 2 cohorts undergoing left dorsolateral prefrontal cortex rTMS as a treatment for depression. RESULTS: Our results reveal changes in thickness in a region of the left rostral anterior cingulate cortex that correlate with clinical response, with this region becoming thicker in patients who respond favorably to rTMS and thinner in patients with a less favorable response. Moreover, the baseline cortical thickness in this region correlates with rTMS treatment response - those patients with thinner cortex before treatment tended to have the most clinical improvement. CONCLUSIONS: This study is the first analysis of longitudinal cortical thickness change with rTMS as a treatment for depression with similar results across two cohorts. These results support further investigation into the use of structural MRI as a possible biomarker of rTMS treatment response.
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