Modulation of Motor Cortex Excitability Predicts Antidepressant Response to Prefrontal Cortex Repetitive Transcranial Magnetic Stimulation
Oliveira-Maia, Albino J. (Berenson-Allen Center for Noninvasive Brain Stimulation)
Press, Daniel (Berenson-Allen Center for Noninvasive Brain Stimulation)
Pascual Leone, Álvaro (Institut Germans Trias i Pujol. Institut Guttmann)

Data:	2017
Resum:	Background: Repetitive transcranial magnetic stimulation (RTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) is a treatment option for patients with medication-resistant major depressive disorder (MDD). However, antidepressant response is variable and there are currently no response predictors with sufficient accuracy for clinical use. Objective: We report on results of an observational open-label study to determine whether the modulatory effect of 10 Hz motor cortex (MC) rTMS is predictive of the antidepressant effect of 10 Hz DLPFC rTMS. Methods: Fifty-one medication-resistant MDD patients were enrolled for a 10-day treatment course of DLPFC rTMS and antidepressant response was assessed according to post-treatment reduction of the 17-item Hamilton Rating Scale for Depression score. Prior to treatment, we assessed the modulation of motor evoked potential (MEP) amplitude by MC rTMS. MEP's were induced with single TMS pulses and measured using surface electromyography. MEP modulation was calculated as the change of mean MEP amplitude after MC rTMS. Results: MEP modulation proved to be a robust predictor of reduction of clinician-rated depression severity following the course of DLPFC rTMS: larger MC rTMS-induced increase of corticospinal excitability anticipated a better antidepressant response. This was found both in univariate analyses (Spearman regression: rho=0. 43, p<0. 005) and a multivariable linear regression model (β=0. 25, p<0. 0001) controlling for baseline depression severity, age and resting motor threshold. Conclusions: These findings suggest that MC rTMS-induced modulation of corticospinal excitability warrants further evaluation as a potential predictive biomarker of antidepressant response to left DLPFC 10 Hz rTMS.
Drets:	Tots els drets reservats.
Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	MDD ; Rtms ; Dorsolateral prefrontal cortex ; Motor cortex ; Excitability ; Antidepressant response prediction
Publicat a:	Brain Stimulation, Vol. 10 Núm. 4 (2017) , p. 787-794

DOI: 10.1016/j.brs.2017.03.013
PMID: 28438543

21 p, 702.3 KB

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