Evaluation of Transcranial Magnetic Stimulation Efficiency in Major Depressive Disorder Patients: A Magnetic Resonance Spectroscopy Study

Abstract

ObjectiveRepetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study evaluated the antidepressant effect of rTMS and examined how it affected N-asetyl aspartate (NAA), choline (Cho), creatine (Cr), lactate (Lac), myoinositol (mIns), glutamate (Glu), glutathione (GSH), and glutamine (Gln) metabolite levels in the left dorsolateral prefrontal cortex (DLPFC) of MDD patients who were not receiving antidepressant medication. MethodsIn total, 18 patients (10 female, 8 male) were evaluated. Each patient underwent H magnetic resonance spectroscopy (H-MRS) before and within 3 days of completion of TMS therapy. All patients completed 20 sessions of rTMS directed at the left DLPFC over a 2-week period. The Hamilton Depression Scale (HAMD) scores of patients were calculated, and their responses to treatment were assessed within 1–3 days of completion of TMS. ResultsWe found statistically significant differences in HAMD scores before and after rTMS. Moreover, the peak metabolite ratios of NAA/Cr, GSH/Cr, and Gln/Cr were significantly higher after rTMS compared to those before rTMS. ConclusionIncreased understanding of the mechanism of action of TMS will improve its application and may stimulate development of new-generation therapeutic agents.

Insight Into the Effects of Clinical Repetitive Transcranial Magnetic Stimulation on the Brain From Positron Emission Tomography and Magnetic Resonance Imaging Studies: A Narrative Review

“…In participants with mood disorders, HF-rTMS has been shown to increase GABA concentration in the target area after a clinical course of stimulation over the left DLPFC (Levitt et al, 2019). Similarly, Erbay et al (2019) reported an increase in Gln/Cr ratio on the left DLPFC after 10 sessions.…”

The exploration of optimized protocol for repetitive transcranial magnetic stimulation in the treatment of methamphetamine use disorder: A randomized sham-controlled study

“…In the current rTMS study of SUD, the widely researched brain area is dorsolateral prefrontal cortex (DLPFC) [4] . Studies have shown that rTMS targeting frontal region affects the levels of prefrontal neurotransmitters GABA and Glu, as well as changes in dopamine receptor binding levels [5] , [6] , [7] , [8] . Besides, changes in cerebral blood oxygen level and electrophysiological functions can also be observed [ 9 , 10 ].…”

Repetitive Transcranial Magnetic Stimulation-Associated Changes in Neocortical Metabolites in Major Depression: A Systematic Review

“…Participants’ mean age ranged from 15.5 to 53 years across studies, with an overall mean ± SD age of 36.8 ± 11.3. Age composition varied and included studies of adolescents (ages 13–17 ( Croarkin et al, 2016 )), adolescents to young adults (ages 15–21 ( Yang et al, 2014 )); and young adults (ages 18–40 ( Zheng et al, 2015 , Zheng et al, 2010 )), with most studies (8/12) focusing on adult patients (ages 20–70 ( Baeken et al, 2017 , Dubin et al, 2016 , Luborzewski et al, 2007 , Erbay et al, 2019 , Zavorotnyy et al, 2020 , Godfrey et al, 2021 , Levitt et al, 2019 , Bhattacharyya et al, 2021 ).…”