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. 2014 Jan;39(2):488-98.
doi: 10.1038/npp.2013.222. Epub 2013 Sep 13.

Resting-state cortico-thalamic-striatal connectivity predicts response to dorsomedial prefrontal rTMS in major depressive disorder

Tim V Salomons  1 , Katharine Dunlop  2 , Sidney H Kennedy  3 , Alastair Flint  3 , Joseph Geraci  4 , Peter Giacobbe  5 , Jonathan Downar  5
Affiliations

Resting-state cortico-thalamic-striatal connectivity predicts response to dorsomedial prefrontal rTMS in major depressive disorder

Tim V Salomons et al. Neuropsychopharmacology. 2014 Jan.

Abstract

Despite its high toll on society, there has been little recent improvement in treatment efficacy for major depressive disorder (MDD). The identification of biological markers of successful treatment response may allow for more personalized and effective treatment. Here we investigate whether resting-state functional connectivity predicted response to treatment with repetitive transcranial magnetic stimulation (rTMS) to dorsomedial prefrontal cortex (dmPFC). Twenty-five individuals with treatment-refractory MDD underwent a 4-week course of dmPFC-rTMS. Before and after treatment, subjects received resting-state functional MRI scans and assessments of depressive symptoms using the Hamilton Depresssion Rating Scale (HAMD17). We found that higher baseline cortico-cortical connectivity (dmPFC-subgenual cingulate and subgenual cingulate to dorsolateral PFC) and lower cortico-thalamic, cortico-striatal, and cortico-limbic connectivity were associated with better treatment outcomes. We also investigated how changes in connectivity over the course of treatment related to improvements in HAMD17 scores. We found that successful treatment was associated with increased dmPFC-thalamic connectivity and decreased subgenual cingulate cortex-caudate connectivity, Our findings provide insight into which individuals might respond to rTMS treatment and the mechanisms through which these treatments work.

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Figures

Figure 1
Figure 1
Baseline connectivity from dorsomedial prefrontal cortex (dmPFC) in relation to Hamilton Depression Rating Scale (HAMD) improvement: regions where high connectivity (orange) or low connectivity (blue) with the dmPFC seed (red) was significantly correlated with reduced depression (HAMD change, high scores indicate improvement) following repetitive transcranial magnetic stimulation (rTMS) to dmPFC.
Figure 2
Figure 2
Baseline connectivity from subgenual cingulate cortex (sgACC) in relation to Hamilton Depression Rating Scale (HAMD) improvement: regions where high connectivity (orange) or low connectivity (blue) with the sgACC seed (red) was significantly correlated with reduced depression (HAMD change, high scores indicate improvement) following repetitive transcranial magnetic stimulation (rTMS) to dorsomedial prefrontal cortex (dmPFC).
Figure 3
Figure 3
Change in connectivity from dorsomedial prefrontal cortex (dmPFC) in relation to Hamilton Depression Rating Scale (HAMD) improvement: regions where increased connectivity (orange) or decreased connectivity (blue) with the dmPFC seed (red) was significantly correlated with reduced depression (HAMD change, high scores indicate improvement) following repetitive transcranial magnetic stimulation (rTMS) to dmPFC.
Figure 4
Figure 4
Change in connectivity from subgenual cingulate cortex (sgACC) in relation to Hamilton Depression Rating Scale (HAMD) improvement: regions where decreased connectivity (blue) with the sgACC seed (red) was significantly correlated with reduced depression (HAMD change, high scores indicate improvement) following repetitive transcranial magnetic stimulation (rTMS) to dorsomedial prefrontal cortex (dmPFC).
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