Altered Transcranial Magnetic Stimulation–Electroencephalographic Markers of Inhibition and Excitation in the Dorsolateral Prefrontal Cortex in Major Depressive Disorder

Voineskos, Daphne; Blumberger, Daniel M.; Zomorrodi, Reza; Rogasch, Nigel C.; Farzan, Faranak; Foussias, George; Rajji, Tarek K.; Daskalakis, Zafiris J.

doi:10.1016/j.biopsych.2018.09.032

Cited by 93 publications

(64 citation statements)

References 60 publications

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“…Evidence suggests that a critical state emerges from a balance of neuronal inhibition and excitation (Beggs and Plenz, 2003;Gireesh and Plenz, 2008;Poil et al, 2012). The GABA and glutamate systems, the primary inhibitory and excitatory transmitters in the brain, have been shown to be altered in MDD (Godfrey et al, 2018;Voineskos et al, 2019). As well as this, neuromodulators such as serotonin and dopamine, which influence neural excitability, are known to be affected in MDD (Belujon and Grace, 2017;Morrissette and Stahl, 2014) and to play a role in cortical activity changes between EC and EO conditions (Wan et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Intrinsic activity temporal structure reactivity to behavioural state change is correlated with depressive symptoms

Duncan

Hsu

Cheng

et al. 2019

Preprint

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Patients with major depressive disorder (MDD) tend to focus their thoughts on their personal problems and negative self-reflection. This negative self-focus has a major impact on patient quality of life and is associated with a range of cognitive deficits. Self-related thoughts, such as those seen in rumination, have been associated with intrinsic activity within cortical midline structures. In normal conditions this intrinsic activity is responsive to behavioural state, changing as an individual switches from an internally to externally oriented context. It was hypothesised that this responsiveness would be blunted in patients with MDD (n = 26; control n = 37) and that the degree to which an individual was fixed in a particular intrinsic state would be correlated with reported ruminatory behaviours. This was tested by measuring intrinsic EEG activity temporal structure, quantified with detrended fluctuation analysis (DFA), in eyes-closed and eyes-open task-free states and contrasting between the conditions. The difference between the internally oriented eyes-closed and externally oriented eyes-open states was then correlated with ruminatory behaviour, measured with the Rumination Response Scale. Healthy controls showed a robust beta band DFA change between states, moving from a critical to sub-critical activity state with the opening of the eyes. This change was not seen in MDD patients, with the eyes-closed DFA remaining similar to that in eyes-open. A negative correlation was seen between the DFA difference and rumination scores over the midline electrodes. These results identify a reduced reactivity of intrinsic activity properties in MDD that is related to greater ruminative symptoms.

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Section: Discussionmentioning

confidence: 99%

Intrinsic activity temporal structure reactivity to behavioural state change is correlated with depressive symptoms

Duncan

Hsu

Cheng

et al. 2019

Preprint

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“…1 The negative TEP deflections at 45 milliseconds (N45) and 100 milliseconds (N100) following the TMS pulse are linked to inhibitory GABA-A and GABA-B receptor-mediated activity, 11 respectively, and have recently been shown to be altered in MDD. Voineskos et al 12 found enhanced N45 and N100 amplitude in 30 MDD patients compared with 30 age-matched and sex-matched healthy participants. These authors also demonstrated that N45 amplitude was a reliable predictor of the depressive state-it classified individuals in the MDD or control group with high sensitivity (80%), specificity (73.3%) and accuracy (76.6%).…”

Section: Pathophysiological Biomarkers Of Mddmentioning

confidence: 98%

“…The negative TEP deflections at 45 milliseconds (N45) and 100 milliseconds (N100) following the TMS pulse are linked to inhibitory GABA‐A and GABA‐B receptor‐mediated activity, respectively, and have recently been shown to be altered in MDD. Voineskos et al . found enhanced N45 and N100 amplitude in 30 MDD patients compared with 30 age‐matched and sex‐matched healthy participants.…”

Section: Major Depressive Disordermentioning

confidence: 99%

The Current and Future Potential of Transcranial Magnetic Stimulation With Electroencephalography in Psychiatry

Hui

Tremblay

Daskalakis

2019

Clin Pharma and Therapeutics

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The search for biological targets in psychiatric disorders is essential to better understand illness mechanisms and also to monitor and predict response to currently available therapeutic interventions. To this end, the combination of transcranial magnetic stimulation with electroencephalography (TMS‐EEG) has emerged as a powerful clinical research tool. TMS‐EEG allows cortical properties, such as excitability, inhibition, oscillatory activity, and connectivity, to be directly probed within a specific region of the cortex. This review will summarize the state of the current literature on TMS‐EEG and its potential to uncover biological targets in psychiatric illnesses, with a focus on major depressive disorder, bipolar disorder, and schizophrenia. Collectively, the reviewed studies suggest that alterations in gamma‐aminobutyric acid‐mediated inhibition and gamma oscillations in the dorsolateral prefrontal cortex and neighboring frontal regions are potential shared biomarkers in psychiatry, highlighting the potential of TMS‐EEG to help identify translational biomarkers.

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“…116 These limitations notwithstanding, promising findings have been observed using this biomarker modality to predict NIN response. [188][189][190] Other biological markers have also been explored in NIN, including genetic and non-genetic peripheral biomarkers and heart rate variability. 44,[191][192][193][194][195][196][197][198][199] Although some positive findings were found, results have been inconsistent, and mostly derived from open studies.…”

Section: Convulsive Modalitiesmentioning

confidence: 99%

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain

Borrione

Bellini

Razza

et al. 2020

Braz. J. Psychiatry

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Current first-line treatments for major depressive disorder (MDD) include pharmacotherapy and cognitive-behavioral therapy. However, one-third of depressed patients do not achieve remission after multiple medication trials, and psychotherapy can be costly and time-consuming. Although nonimplantable neuromodulation (NIN) techniques such as transcranial magnetic stimulation, transcranial direct current stimulation, electroconvulsive therapy, and magnetic seizure therapy are gaining momentum for treating MDD, the efficacy of non-convulsive techniques is still modest, whereas use of convulsive modalities is limited by their cognitive side effects. In this context, we propose that NIN techniques could benefit from a precision-oriented approach. In this review, we discuss the challenges and opportunities in implementing such a framework, focusing on enhancing NIN effects via a combination of individualized cognitive interventions, using closed-loop approaches, identifying multimodal biomarkers, using computer electric field modeling to guide targeting and quantify dosage, and using machine learning algorithms to integrate data collected at multiple biological levels and identify clinical responders. Though promising, this framework is currently limited, as previous studies have employed small samples and did not sufficiently explore pathophysiological mechanisms Brazilian Psychiatric Association 0 0 0 0 0 0 0 0 -0 0 0 2 -7 3 1 6 -1 1 8 5 associated with NIN response and side effects. Moreover, cost-effectiveness analyses have not been performed. Nevertheless, further advancements in clinical trials of NIN could shift the field toward a more ''precision-oriented'' practice. DisclosureZ-DD is listed as inventor on patents/patent applications related to brain stimulation technology, assigned to Columbia University and NEVA Electromagnetics, not licensed, and with no remuneration. Although he is an employee of the U.S. government, the views expressed Braz J Psychiatry. 2020;00 (00) Precision NIN for depression

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Altered Transcranial Magnetic Stimulation–Electroencephalographic Markers of Inhibition and Excitation in the Dorsolateral Prefrontal Cortex in Major Depressive Disorder

Cited by 93 publications

References 60 publications

Intrinsic activity temporal structure reactivity to behavioural state change is correlated with depressive symptoms

Intrinsic activity temporal structure reactivity to behavioural state change is correlated with depressive symptoms

The Current and Future Potential of Transcranial Magnetic Stimulation With Electroencephalography in Psychiatry

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain

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