Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-06-02T20:53:55.379Z Has data issue: false hasContentIssue false
  • English
  • Français

HF-rTMS Treatment in Medication-Resistant Melancholic Depression: Results from 18FDG-PET Brain Imaging

Published online by Cambridge University Press:  07 November 2014

Chris Baeken ,
Rudi De Raedt ,
Christian Van Hove ,
Peter Clerinx ,
Johan De Mey  and
Axel Bossuyt
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: High frequency repetitive transcranial magnetic stimulation (HF-rTMS) of the left dorsolateral prefrontal cortex (DLPFC) might be a promising strategy to treat depression, but not all patients show a positive outcome.

Objective: In this open study, we evaluate whether a favorable HF-rTMS treatment outcome could be predicted by baseline prefrontal brain glucose metabolism (CMRglc), measured by 18fluorodeoxyglucose positron emission tomography (18FDG-PET).

Methods: A sample of 21 antidepressant-free, treatment-resistant depression (TRD) patients of the melancholic subtype received 10 sessions of HF-rTMS delivered on the left DLPFC. Patients underwent a static 18FDG-PET before and after HF-rTMS treatment.

Results: Forty-three percent of the patients showed a reduction of at least 50% on their Hamilton Rating Scale for Depression scores. Higher baseline metabolic activities in the DLPFC and the anterior cingulate cortex (ACC) were associated with better clinical outcome. Successful HF-rTMS treatment was related to metabolic changes in subdivisions of the ACC (Brodmann areas 24 and 32).

Conclusion: This biological impact of HF-rTMS on regional brain CMRglc explains to some extent how HF-rTMS may improve moods in TRD patients. Larger sham-controlled HF-rTMS treatment studies are needed to confirm these results.

Type
Original Research
Information
CNS Spectrums , Volume 14 , Issue 8 , August 2009 , pp. 439 - 448
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Schlaepfer, TE, Kosel, M, Nemeroff, CB. Efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of affective disorders. Neuropsychopharmacology. 2003;28:201–205.CrossRefGoogle ScholarPubMed
2.O'Reardon, JP, Solvason, HB, Janicak, PG, et al.Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007;62:1208–1216.CrossRefGoogle ScholarPubMed
3.Burt, T, Lisanby, SH, Sackeim, HA. Neuropsychiatric applications of transcranial magnetic stimulation: a meta analysis. Int J Neuropsychopharmacol. 2002;5:73–103.CrossRefGoogle ScholarPubMed
4.George, MS, Nahas, Z, Li, X, et al.Novel treatments of mood disorders based on brain circuitry (ECT, MST, TMS, VNS, DBS). Semin Clin Neuropsychiatry. 2002;7:293–304.CrossRefGoogle ScholarPubMed
5.Simons, W, Dierick, M. Transcranial magnetic stimulation as a therapeutic tool in psychiatry. World J Biol Psychiatry. 2005;6:6–25.CrossRefGoogle ScholarPubMed
6.Paus, T, Barrett, J. Transcranial magnetic stimulation (TMS) of the human frontal cortex: implications for repetitive TMS treatment of depression. J Psychiatry Neurosci. 2004;29:268–279.Google ScholarPubMed
7.Fitzgerald, PB, Oxley, TJ, Laird, AR, Kulkarni, J, Egan, GF, Daskalakis, ZJ. An analysis of functional neuroimaging studies of dorsolateral prefrontal cortical activity in depression. Psychiatry Res. 2006;148:33–45.CrossRefGoogle ScholarPubMed
8.Martin, JL, Barbanoj, MJ, Schlaepfer, TE, Thompson, E, Perez, V, Kulisevsky, J. Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis. Br J Psychiatry. 2003;182:480–491.CrossRefGoogle ScholarPubMed
9.Gross, M, Nakamura, L, Pascual-Leone, A, Fregni, F. Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies. Acta Psychiatr Scand. 2007;116:165–173.CrossRefGoogle ScholarPubMed
10.Post, A, Keck, ME. Transcranial magnetic stimulation as a therapeutic tool in psychiatry: what do we know about the neurobiological mechanisms? J Psychiatr Res. 2001;35:193–215.CrossRefGoogle ScholarPubMed
11.Ben-Shachar, D, Gazawi, H, Riboyad-Levin, J, Klein, E. Chronic repetitive transcranial magnetic stimulation alters beta-adrenergic and 5-HT2 receptor characteristics in rat brain. Brain Res. 1999;816:78–83.CrossRefGoogle ScholarPubMed
12.Strafella, AP, Paus, T, Barrett, J, Dagher, A. Repetitive transcranial magnetic stimulation of the human prefrontal cortex induces dopamine release in the caudate nucleus. J Neurosci. 2001;21:RC157.CrossRefGoogle ScholarPubMed
13.Speer, AM, Kimbrell, TA, Wasserman, ED, et al.Opposite effects of high and low frequency rTMS on regional brain activity in depressed patients. Biol Psychiatry. 2000;48:1133–1141.CrossRefGoogle ScholarPubMed
14.Knoch, D, Treyer, V, Regard, M, Müri, RM, Buck, A, Weber, B. Lateralized and frequency-dependent effects of prefrontal rTMS on regional cerebral blood flow. Neuroimage. 2006;31:641–648.CrossRefGoogle ScholarPubMed
15.Kimbrell, TA, Little, JT, Dunn, RT, et al.Frequency dependence of antidepressant response to left prefrontal repetitive transcranial magnetic stimulation as a function of baseline cerebral glucose metabolism. Biol Psychiatry. 1999;46:1603–1613.CrossRefGoogle ScholarPubMed
16.Teneback, CC, Nahas, Z, Speer, AM, et al.Changes in prefrontal cortex and paralimbic activity in depression following two weeks of daily left prefrontal TMS. J Neuropsychiatry Clin Neurosci. 1999;11:426–435.Google ScholarPubMed
17.Eschweiler, GW, Wegerer, C, Schlotter, W, et al.Left prefrontal activation predicts therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) in major depression. Psychiatry Res. 2000;99:161–172.CrossRefGoogle ScholarPubMed
18.Langguth, B, Wiegand, R, Kharraz, A, et al.Pre-treatment anterior cingulate activity as a predictor of antidepressant response to repetitive transcranial magnetic stimulation (rTMS). Neuro Endocrinol Lett. 2007;28:633–638.Google ScholarPubMed
19.Nahas, Z, Teneback, CC, Kozel, A, et al.Brain effects of TMS delivered over prefrontal cortex in depressed adults: role of stimulation frequency and coil-cortex distance. J Neuropsychiatry Clin Neurosci. 2001;13:459–470.CrossRefGoogle ScholarPubMed
20.Paus, T, Castro-Alamancos, MA, Petrides, M. Cortico-cortical connectivity of the human mid-dorsolateral frontal cortex and its modulation by repetitive transcranial magnetic stimulation. Eur J Neurosci. 2001;14:1405–1411.CrossRefGoogle ScholarPubMed
21.Li, X, Nahas, Z, Kozel, FA, Anderson, B, Bohning, DE, George, MS. Acute left prefrontal transcranial magnetic stimulation in depressed patients is associated with immediately increased activity in prefrontal cortical as well as subcortical regions. Biol Psychiatry. 2004;55:882–890.CrossRefGoogle ScholarPubMed
22.Luborzewski, A, Schubert, F, Seifert, F, et al.Metabolic alterations in the dorsolateral prefrontal cortex after treatment with high-frequency repetitive transcranial magnetic stimulation in patients with unipolar major depression. J Psychiatr Res. 2007;41:606–615.CrossRefGoogle ScholarPubMed
23.Brakemeier, EL, Luborzewski, A, Danker-Hopfe, H, Kathmann, N, Bajbouj, MJ. Positive predictors for antidepressive response to prefrontal repetitive transcranial magnetic stimulation (rTMS). J Psychiatr Res. 2007;41:395–403.CrossRefGoogle ScholarPubMed
24.Mayberg, HS, Brannan, SK, Mahurin, RK, et al.Cingulate function in depression: A potential predictor of treatment response. Neuroreport. 1997;8:1057–1061.CrossRefGoogle ScholarPubMed
25.Mayberg, HS. Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimised treatment. Br Med Bull. 2003;65:193–207.CrossRefGoogle ScholarPubMed
26.Dougherty, DD, Rauch, SL. Brain correlates of antidepressant treatment outcome from neuroimaging studies in depression. Psychiatr Clin North Am. 2007;30:91–103.CrossRefGoogle ScholarPubMed
27.Drevets, WC. Functional neuro-imaging studies of depression: the anatomy of melancholia. Annu Rev Med. 1998;49:341–361.CrossRefGoogle Scholar
28.Leventhal, AM, Rehm, LP. The empirical status of melancholia: implications for psychology. Clin Psychol Rev. 2005;25:25–44.CrossRefGoogle ScholarPubMed
29.Thase, ME, Rush, A. When at first you don't succeed: Sequential strategies for antidepressant nonresponders. J Clin Psychiatry. 1997;58(suppl 13):23–29.Google ScholarPubMed
30.Rush, AJ, Thase, ME, Dubé, S. Research issues in the study of difficult-to-treat depression. Biol Psychiatry. 2003;53:743–753.CrossRefGoogle Scholar
31. Van Strien, JW. Handvoorkeur en taaldominantie. Neuropraxis. 2001;2:10–15.Google Scholar
32.Sheehan, DV, Lecrubier, Y, Sheehan, KH, et al.The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(suppl 20):22–33.Google ScholarPubMed
33.Hamilton, M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967;6:278–296.CrossRefGoogle ScholarPubMed
34.Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–571.CrossRefGoogle ScholarPubMed
35.Beck, AT, Steer, RA. Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol. 1984;40:1365–1367.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
36.Peleman, K, Van Schuerbeek, P, Luypaert, R, et al.Using 3D-MRI to localize the Dorsolateral Prefrontal Cortex in TMS Research. World J Biol Psychiatry. (in press).Google Scholar
37.Wassermann, EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. Electroencephalogr Clin Neurophysiol. 1998;108:1–16.CrossRefGoogle ScholarPubMed
38.Keel, JC, Smith, MJ, Wassermann, EM. A safety screening questionnaire for transcranial magnetic stimulation. Clin Neurophysiol. 2001;112:720.CrossRefGoogle ScholarPubMed
39.Anand, S, Hotson, J. Transcranial magnetic stimulation: neurophysiological applications and safety. Brain Cogn. 2002;50:366–386.CrossRefGoogle ScholarPubMed
40.Ashburner, J, Friston, KJ. Nonlinear Spatial Normalization using Basis Functions. Hum Brain Mapp. 1999;7:254–266.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
41.Maldjian, JA, Laurienti, PJ, Kraft, RA, Burdette, JH. An automated method for neuroanatomic and cytoarchitectonic atlas-based interrogation of fmri data sets. Neuroimage. 2003;19:1233–1239.CrossRefGoogle ScholarPubMed
42.Bush, G, Luu, P, Posner, MI. Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci. 2000;4:215–222.CrossRefGoogle ScholarPubMed
43.Davidson, RJ, Lewis, DA, Alloy, LB, et al.Neural and behavioral substrates of mood and mood regulation. Biol Psychiatry. 2002;52:478–502.CrossRefGoogle ScholarPubMed
44.Evans, KC, Dougherty, DD, Pollack, MH, Rauch, SL. Using neuroimaging to predict treatment response in mood and anxiety disorders. Ann Clin Psychiatry. 2006;18:33–42.CrossRefGoogle ScholarPubMed
45.Pridmore, S, Bruno, R, Turnier-Shea, Y, Reid, P, Rybak, M. Comparison of unlimited numbers of rapid transcranial magnetic stimulation and ECT treatment sessions in major depressive episode. Int J Neuropsychopharmacol. 2000;3:129–134.CrossRefGoogle ScholarPubMed
46.Figiel, GS, Epstein, C, McDonald, WM, et al.The use of rapid-rate transcranial magnetic stimulation in refractory depressed patients. J Neuropsychiatry Clin Neurosci. 1998;10:20–25.CrossRefGoogle ScholarPubMed
47.Grunhaus, L, Dannon, PN, Schreiber, S, et al.Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder: an open study. Biol Psychiatry. 2000;47:314–324.CrossRefGoogle ScholarPubMed
48.Holtzheimer, PE 3rd, Russo, J, Claypoole, KH, Roy-Byrne, P, Avery, DH. Shorter duration of depressive episode may predict response to repetitive transcranial magnetic stimulation. Depress Anxiety. 2004;19:24–30.CrossRefGoogle ScholarPubMed
49.Loo, CK, Mitchell, PB. A review of the efficacy of transcranial magnetic stimulation (TMS) treatment for depression, and current and future strategies to optimize efficacy. J Affect Disord. 2005;88:255–267.CrossRefGoogle ScholarPubMed
50.Kimbrell, TA, Ketter, TA, George, MS, et al.Regional cerebral glucose utilization in patients with a range of severities of unipolar depression. Biol Psychiatry. 2002;51:237–252.CrossRefGoogle ScholarPubMed
51.Conca, A. Peschina, W, Konig, P, Fritzsche, H, Hausmann, A. Effect of chronic repetitive transcranial magnetic stimulation on regional cerebral blood flow and regional cerebral glucose uptake in drug treatment-resistant depressives. A brief report. Neuropsychobiology. 2002;45:27–31.CrossRefGoogle ScholarPubMed
52.Brody, AL, Saxena, S, Silverman, DH, et al.Brain metabolic changes in major depressive disorder from pre- to post-treatment with paroxetine. Psychiatry Res. 1999;91:127–139.CrossRefGoogle ScholarPubMed
53.Brody, AL, Saxena, S, Mandelkern, MA, Fairbanks, LA, Ho, ML, Baxter, LR. Brain metabolic changes associated with symptom factor improvement in major depressive disorder. Biol Psychiatry. 2001;50:171–178.CrossRefGoogle ScholarPubMed
54.Mottaghy, FM, Keller, CE, Gangitano, M, et al.Correlation of cerebral blood flow and treatment effects of repetitive transcranial magnetic stimulation in depressed patients. Psychiatry Res. 2002;115:1–14.CrossRefGoogle ScholarPubMed
55.Catafau, AM, Perez, V, Gironell, A, et al.SPECT mapping of cerebral activity changes induced by repetitive transcranial magnetic stimulation in depressed patients. A pilot study. Psychiatry Res. 2001;106:151–160.CrossRefGoogle ScholarPubMed
56.Nadeau, SE, McCoy, KJ, Crucian, GP, et al.Cerebral blood flow changes in depressed patients after treatment with repetitive transcranial magnetic stimulation: evidence of individual variability. Neuropsychiatry Neuropsychol Behav Neurol. 2002;15:159–175.Google ScholarPubMed
57.Loo, CK, Sachde, PS, Haindl, W, et al.High (15 Hz) and low (1 Hz) frequency transcranial magnetic stimulation have different acute effects on regional cerebral blood flow in depressed patients. Psychol Med. 2003;33:997–1006.CrossRefGoogle ScholarPubMed
58.Holthoff, VA, Beuthien-Baumann, B, Zündorf, G, et al.Changes in brain metabolism associated with remission in unipolar major depression. Acta Psychiatr Scand. 2004;110:184–194.CrossRefGoogle ScholarPubMed
59.Shajahan, PM, Glabus, MF, Steele, JD, et al.Left dorso-lateral repetitive transcranial magnetic stimulation affects cortical excitability and functional connectivity, but does not impair cognition in major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26:945–954.CrossRefGoogle Scholar
60.Wu, J, Buchsbaum, MS, Gillin, J, et al.Prediction of antidepressant effects of sleep deprivation by metabolic rates in the ventral anterior cingulate and medial prefrontal cortex. Am J Psychiatry. 1999;156:1149–1158.CrossRefGoogle ScholarPubMed
61.Mayberg, HS, Brannan, SK, Tekell, JL, Silva, JA, Mahurin, RK, McGinnis, S, Jerabek, PA. Regional metabolic effects of fluoxetine in major depression: serial changes and relationship to clinical response. Biol Psychiatry. 2000;48:830–843.CrossRefGoogle ScholarPubMed
62.Nobler, MS, Oquendo, MA, Kegeles, LS, et al.Decreased regional brain metabolism after ect. Am J Psychiatry. 2001;158:305–308.CrossRefGoogle ScholarPubMed
63.Takano, H, Motohashi, N, Uema, T, et al.Changes in regional cerebral blood flow during acute electroconvulsive therapy in patients with depression: positron emission tomographic study. Br J Psychiatry. 2007;190:63–68.CrossRefGoogle ScholarPubMed
64.Schmidt, EZ, Reininghaus, B, Enzinger, C, Ebner, C, Hofmann, P, Kapfhammer, HP. Changes in brain metabolism after ECT-positron emission tomography in the assessment of changes in glucose metabolism subsequent to electroconvulsive therapy–lessons, limitations and future applications. J Affect Disord. 2008;106:203–208.CrossRefGoogle ScholarPubMed
65.Pizzagalli, D, Pascual-Marqui, RD, Nitschke, JB, et al.Anterior cingulate activity as a predictor of degree of treatment response in major depression: evidence from brain electrical tomography analysis. Am J Psychiatry. 2001;158:405–415.CrossRefGoogle ScholarPubMed
66.Kito, S, Fujita, K, Koga, Y. Changes in regional cerebral blood flow after repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex in treatment-resistant depression. J Neuropsychiatry Clin Neurosci. 2008;20:74–80.CrossRefGoogle ScholarPubMed
67.Drevets, WC. Functional anatomical abnormalities in limbic and prefrontal cortical structures in major depression. Prog Brain Res. 2000;126:413–431.CrossRefGoogle ScholarPubMed
68.Berman, RM, Narasimhan, M, Sanacora, G, et al.A randomized clinical trial of repetitive transcranial magnetic stimulation in the treatment of major depression. Biol Psychiatry. 2000;47:332–337.CrossRefGoogle ScholarPubMed
69.Goldapple, K, Segal, Z, Garson, C, et al.Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy. Arch Gen Psychiatry. 2004;61:34–41.CrossRefGoogle ScholarPubMed
70.Gershon, AA, Dannon, PN, Grunhaus, L. Transcranial magnetic stimulation in the treatment of depression. Am J Psychiatry. 2003;160:835–845.CrossRefGoogle ScholarPubMed
71.Drevets, WC, Price, JL, Furey, ML. Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression. Brain Struct Funct. 2008;213:93–118.CrossRefGoogle ScholarPubMed