Longer depressive episode duration negatively influences HF-rTMS treatment response: a cerebellar metabolic deficiency?

Brain Imaging and Behavior
Guo-Rong Wu, Chris Baeken

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is an evidence based neurostimulation modality used to treat patients with Major Depressive Disorder (MDD). In spite that the duration of current a depressive episode has been put forward as a negative predictor for clinical outcome, little is known about the underlying neurobiological mechanisms of this phenomenon. To address this important issue, in a sample of 43 melancholic stage III treatment resistant antidepressant-free refractory MDD patients, we reanalysed regional cerebral glucose metabolism (CMRglc) before high frequency (HF)-rTMS treatment, applied to the left dorsolateral prefrontal cortex (DLPFC). Besides that a lower baseline cerebellar metabolic activity indicated negative clinical response, a longer duration of the depressive episode was a negative indicator for recovery and negatively influenced cerebellar CMRglc. This exploratory (18)FDG PET study is the first to demonstrate that the clinical response of HF-rTMS treatment in TRD patients may depend on the metabolic state of the cerebellum. Our observations could imply that for left DLPFC HF-rTMS non-responders other brain localisations for stimulation, more specifically the cerebellum, may be warranted.

References

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Citations

Oct 26, 2018·Nordic Journal of Psychiatry·Anton Filip SvenssonAxel Nordenskjöld
Jun 15, 2018·Frontiers in Human Neuroscience·Xiaoqin DuanWei Yang
Oct 13, 2021·The Cerebellum·Frank Van OverwalleKris Baetens

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Methods Mentioned

BETA
imaging technique

Software Mentioned

OSEM
MarsBaR
SPSS
xjView MATLAB
SPM8

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