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Major depressive disorder is associated with abnormal interoceptive activity and functional connectivity in the insula. Neurosci Biobehav Rev 34, 592–605.Īvery, J.A., Drevets, W.C., Moseman, S.E., Bodurka, J., Barcalow, J.C., and Simmons, W.K. Is subcortical-cortical midline activity in depression mediated by glutamate and GABA? A cross-species translational approach. Psychother Psychosom 83, 298–307.Īlcaro, A., Panksepp, J., Witczak, J., Hayes, D.J., and Northoff, G. Decreased occipital cortical glutamate levels in response to successful cognitive-behavioral therapy and pharmacotherapy for major depressive disorder. We demonstrated therapeutic potential and good tolerance of VC rTMS in MDD patients, indicated by biomarkers of fMRI measurement.Ībdallah, C.G., Niciu, M.J., Fenton, L.R., Fasula, M.K., Jiang, L., Black, A., Rothman, D.L., Mason, G.F., and Sanacora, G.
Treatment reduced the initially abnormal increase in resting state functional connectivity from the VC to the pre/subgenual anterior cingulate cortex at day 5, especially in the individualized group. Changes in VC task-related functional MRI correlated with symptomatic reduction in the individualized group. The individualized group exhibited the greatest change in HAMD-24 scores after VC rTMS for 5 days ( F=5.53, P=0.005), which were maintained during follow-up period ( F=4.22, P=0.016).
Clinical outcome was measured by Hamilton Depression Rating Scale (HAMD-24) at days 0, 1, 3, 5 and after terminating rTMS, with follow-up at four weeks. Neuronavigated rTMS (10 Hz, 90% of resting motor threshold, 1,600 pulses over 20 min twice per day) was performed over the VC for five days. To determine whether repetitive transcranial magnetic stimulation (rTMS) of the visual cortex (VC) provides effective and well-tolerated treatment and whether magnetic resonance imaging (MRI) measures functional change of the VC as a biomarker of therapeutic effect in major depressive disorder (MDD), we performed a sham-controlled, double-blind, randomized, three-arm VC rTMS treatment study in 74 MDD patients.
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