Publication Type Academic Article
Authors Lan M, Chhetry B, Liston C, Mann J, Dubin M
Journal Brain Stimul
Volume 9
Issue 4
Pagination 577-83
Date Published 03/02/2016
ISSN 1876-4754
Keywords Cerebral Cortex, Depressive Disorder, Major, Depressive Disorder, Treatment-Resistant, Transcranial Magnetic Stimulation
Abstract BACKGROUND: Repetitive transcranial magnetic stimulation (TMS) is an FDA-approved antidepressant treatment but little is known of its mechanism of action. Specifically, downstream effects of TMS remain to be elucidated. OBJECTIVE/HYPOTHESIS: This study aims to identify brain structural changes from TMS treatment of a treatment resistant depressive episode through an exploratory analysis. METHODS: Twenty-seven subjects in a DSM-IV current major depressive episode and on a stable medication regimen had a 3T magnetic resonance T1 structural scan before and after five weeks of standard TMS treatment to the left dorsolateral prefrontal cortex. Twenty-seven healthy volunteer (HVs) subjects had the same brain MRI acquisition. Voxel-based morphometry was performed using high dimensional non-linear diffusomorphic anatomical registration (DARTEL). RESULTS: Six clusters of gray matter volume (GMV) that were lower in pre-treatment MRIs of depressed subjects than in HVs. GMV in four of these regions increased in MDD after TMS treatment by 3.5-11.2%. The four brain regions that changed with treatment were centered in the left anterior cingulate cortex, the left insula, the left superior temporal gyrus and the right angular gyrus. Increases in the anterior cingulate GMV with TMS correlated with improvement in depression severity. CONCLUSIONS: To our knowledge, this is the first study of brain structural changes during TMS treatment of depression. The affected brain areas are involved in cognitive appraisal, decision-making and subjective experience of emotion. These effects may have potential relevance for the antidepressant action of TMS.
DOI 10.1016/j.brs.2016.02.011
PubMed ID 27017072
PubMed Central ID PMC5554068
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