Functional and Structural Connectivity Between the Left Dorsolateral Prefrontal Cortex and Insula Could Predict the Antidepressant Effects of Repetitive Transcranial Magnetic Stimulation

Fu, Yixiao; Long, Zhiliang; Luo, Qiang; Xu, Z.; Xiang, Yisijia; Du, Wanyi; Cao, Yuanyuan; Cheng, Xiaoli; Li, Du

doi:10.3389/fnins.2021.645936

Cited by 23 publications

(19 citation statements)

References 45 publications

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“…Similar to results from functional connectivity studies, a DTI study showed pre-rTMS structural changes in white matter tracks related to therapeutic improvement. A study by Fu et al (2021) showed baseline FA in fiber tracts from the DLPFC to the insula correlated with symptom improvement in mood disorders patients. The authors found the same correlation when comparing pre-rTMS functional connectivity of the DLPFC and the insula and therapeutic effects.…”

Section: Diffusion Tensor Imaging Evaluation Of Structural Integritymentioning

confidence: 99%

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

2022

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Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a therapeutic tool to alleviate symptoms for neurological and psychiatric diseases such as chronic pain, stroke, Parkinson’s disease, major depressive disorder, and others. Although the therapeutic potential of rTMS has been widely explored, the neurological basis of its effects is still not fully understood. Fortunately, the continuous development of imaging techniques has advanced our understanding of rTMS neurobiological underpinnings on the healthy and diseased brain. The objective of the current work is to summarize relevant findings from positron emission tomography (PET) and magnetic resonance imaging (MRI) techniques evaluating rTMS effects. We included studies that investigated the modulation of neurotransmission (evaluated with PET and magnetic resonance spectroscopy), brain activity (evaluated with PET), resting-state connectivity (evaluated with resting-state functional MRI), and microstructure (diffusion tensor imaging). Overall, results from imaging studies suggest that the effects of rTMS are complex and involve multiple neurotransmission systems, regions, and networks. The effects of stimulation seem to not only be dependent in the frequency used, but also in the participants characteristics such as disease progression. In patient populations, pre-stimulation evaluation was reported to predict responsiveness to stimulation, while post-stimulation neuroimaging measurements showed to be correlated with symptomatic improvement. These studies demonstrate the complexity of rTMS effects and highlight the relevance of imaging techniques.

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Section: Diffusion Tensor Imaging Evaluation Of Structural Integritymentioning

confidence: 99%

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

2022

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“…However, the short-/long-term potentiation of synapses and rapid dynamic alterations in GM density have been previously reported after rTMS treatment [107,108], suggesting that structural changes could be triggered by high-frequency rTMS pulses. The occurrence of structural alterations has been related to the triggering of structural neuroplasticity as a counterpart of changes in functional processing, especially with regard to the effects of rTMS on strengthening brain WM connectivity between the left DLPFC and insula targeted by rTMS stimulation [109]. Conversely, the time-course of GM changes in the study of May et al [108], after a 5-day treatment with 1 Hz rTMS at an intensity of 110% motor threshold (MT), suggested that GM modification could reflect the fast adjustment of neuronal systems at the cellular level, such as spine and synapse turnover, rather than slower evolving mechanisms, such as neuronal or glial cell genesis [18,110].…”

Section: Discussionmentioning

confidence: 99%

Repetitive Transcranial Magnetic Stimulation (rTMS) of Dorsolateral Prefrontal Cortex May Influence Semantic Fluency and Functional Connectivity in Fronto-Parietal Network in Mild Cognitive Impairment (MCI)

et al. 2022

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Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique that is increasingly used as a nonpharmacological intervention against cognitive impairment in Alzheimer’s disease (AD) and other dementias. Although rTMS has been shown to modify cognitive performances and brain functional connectivity (FC) in many neurological and psychiatric diseases, there is still no evidence about the possible relationship between executive performances and resting-state brain FC following rTMS in patients with mild cognitive impairment (MCI). In this preliminary study, we aimed to evaluate the possible effects of rTMS of the bilateral dorsolateral prefrontal cortex (DLPFC) in 27 MCI patients randomly assigned to two groups: one group received high-frequency (10 Hz) rTMS (HF-rTMS) for four weeks (n = 11), and the other received sham stimulation (n = 16). Cognitive and psycho-behavior scores, based on the Repeatable Battery for the Assessment of Neuropsychological Status, Beck Depression Inventory-II, Beck Anxiety Inventory, Apathy Evaluation Scale, and brain FC, evaluated by independent component analysis of resting state functional MRI (RS-fMRI) networks, together with the assessment of regional atrophy measures, evaluated by whole-brain voxel-based morphometry (VBM), were measured at baseline, after five weeks, and six months after rTMS stimulation. Our results showed significantly increased semantic fluency (p = 0.026) and visuo-spatial (p = 0.014) performances and increased FC within the salience network (p ≤ 0.05, cluster-level corrected) at the short-term timepoint, and increased FC within the left fronto-parietal network (p ≤ 0.05, cluster-level corrected) at the long-term timepoint, in the treated group but not in the sham group. Conversely, regional atrophy measures did not show significant longitudinal changes between the two groups across six months. Our preliminary findings suggest that targeting DLPFC by rTMS application may lead to a significant long-term increase in FC in MCI patients in a RS network associated with executive functions, and this process might counteract the progressive cortical dysfunction affecting this domain.

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“…Disrupted activity of the frontal ECN has been observed for depression, anxiety, and bipolar disorder (22,(37)(38)(39). Engagement of the parietal areas in mood and anxiety disorders has been proposed as a compensatory mechanism in response to impaired function of frontal areas (36).Moreover, the frontal ECN has been suggested as a neural marker of clinical responsivity to treatment (40) and has been used as a target during antidepressant treatment with transcranial magnetic stimulation (41). In the present sample, these connectivity changes were in general associated with mood lability but not consistently with depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

Triple network model of brain connectivity changes related to adverse mood effects in an oral contraceptive placebo-controlled trial

Hidalgo-Lopez

Engman

Sundström‐Poromaa

et al. 2022

Preprint

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Combined oral contraceptives (COC) are among the most commonly used contraceptive methods worldwide, and mood side effects are the major reason for discontinuation of treatment. We here investigate the directed connectivity patterns associated with the mood side effects of an androgenic COC in a double-blind randomized, placebo-controlled trial in women with a history of affective COC side effects (n=34). We used spectral dynamic causal modeling on a triple network model consisting of the default mode network (DMN), salience network (SN), and executive central network (ECN). Within this framework, we assessed the treatment-related changes in directed connectivity associated with adverse mood side effects. Overall, during COC use, we found a pattern of enhanced connectivity within the DMN and decreased connectivity within the ECN. The dorsal anterior cingulate cortex mediates an increased recruitment of the DMN by the ECN during treatment. Mood lability was the most prominent COC-induced symptom and also arose as the side effect most consistently related to connectivity changes. Connections that were related to increased mood lability showed increased connectivity during COC treatment, while connections that were related to decreased mood lability showed decreased connectivity during COC treatment. Among these, the connections with the highest effect size could also predict the participants' treatment group above chance. Significance Statement Mood side effects are the major reason for discontinuation of oral contraceptive (OC) use. However, the neural substrate underlying these adverse mood effects is still unknown. Here, we investigate the connectivity changes during OC use in women with a history of OC-related mood side effects. We show that mood lability experienced during OC use relates to connectivity patterns previously reported across different mood disorders. The dorsal anterior cingulate cortex, crucial for emotional and cognitive regulation, arose as a mediator area between networks. These neural dynamics during OC treatment may affect cognitive processes underlying mood stability. These findings have important implications for women's mental health and well-being.

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Functional and Structural Connectivity Between the Left Dorsolateral Prefrontal Cortex and Insula Could Predict the Antidepressant Effects of Repetitive Transcranial Magnetic Stimulation

Cited by 23 publications

References 45 publications

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

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

Repetitive Transcranial Magnetic Stimulation (rTMS) of Dorsolateral Prefrontal Cortex May Influence Semantic Fluency and Functional Connectivity in Fronto-Parietal Network in Mild Cognitive Impairment (MCI)

Triple network model of brain connectivity changes related to adverse mood effects in an oral contraceptive placebo-controlled trial

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