Repetitive transcranial magnetic stimulation modulates the impact of a negative mood induction

Abstract

High frequency repetitive Transcranial Magnetic Stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been found to alleviate depressive symptoms. However, the mechanisms driving these effects are still poorly understood. In the current study, we tested the idea that this intervention protects against negative mood shifts following emotional provocation. We furthermore explored changes in EEG activity (frontal alpha asymmetry) and effects on attentional processing (emotional Stroop). To this end, 23 healthy individuals participated in two sessions separated by one week, whereby they once received 15 min of 10Hz rTMS stimulation (1500 pulses) at 110% of the individual motor threshold, and once sham stimulation. Then, negative mood was induced using sad movie clips. The results revealed a significantly stronger mood decline following rTMS compared to sham stimulation. No changes were observed in frontal alpha asymmetry and attentional processing. Our findings are at odds with the view that high frequency rTMS over the left DLPFC directly protects against the induction of negative mood, but rather suggest that it enhances the effects of emotional provocation. Possibly, in healthy young individuals, this stimulation protocol heightens susceptibility to mood induction procedures in general.

Recent Advances in Non-invasive Brain Stimulation for Major Depressive Disorder

“…There are clear differences in antidepressant mechanism, tolerance and acceptability between rTMS and ECT (Table 2 ). The antidepressant effects of rTMS and ECT in MDD have been compared in numerous studies (Möbius et al, 2017 ). Chen et al ( 2017 ) conducted a meta-analysis including 25 clinical RCTs involving 1288 MDD patients.…”

Neural correlates of cue‐ and stress‐induced craving in gambling disorders: implications for transcranial magnetic stimulation interventions

“…This may be achieved using cognitive behavioral therapy (CBT), which has shown efficacy in the treatment of GD (Cowlishaw et al ., ), as well as pharmacotherapies, including mood stabilizers (van Amelsvoort & Hernaus, ). More recently, high‐frequency rTMS of the DLPFC has been proposed as a novel intervention to modulate executive control circuits (Hanlon et al ., ; Lantrip et al ., ; Möbius et al ., ), a mechanism which may allow improving cognitive control over gambling cues, and also over negative emotional states, as reviewed in the next Section.…”

“…Importantly, only few studies have investigated whether DLPFC rTMS may help addressing a number of other critical, disabling behavioral hallmarks of the addiction, such as impaired executive functioning and emotion regulation (Table ). In this regard, useful insights may come from the depression research community indicating that high‐frequency rTMS of the DLPFC improves executive functions and cognitive control over negative emotions (Lantrip et al ., ; Möbius et al ., ; Şalçini et al ., ). Proving that DLPFC rTMS in patients with addictions can address also these deficits can be as important as reducing craving, as these aspects are related, and also because impaired executive functioning and cognitive control over emotion may represent important transdiagnostic phenotypes across addictions and other psychiatric disorders.…”

“…Although the literature on the use of rTMS is still relatively small and sparse, several studies in patients with SUDs have reported a decrease in craving, particularly cue-induced craving, following rTMS. The anti-craving properties of this intervention seem to be related to its ability to regulate corticolimbic-striatal circuits and enhance prefrontal control circuit (Hanlon et al, 2013;Lantrip et al, 2017;M€ obius et al, 2017). As alterations in these circuits have been shown to underlie the emergence of gambling urges, rTMS may represent a potential treatment also for GD patients.…”

Affective Processing in Non-invasive Brain Stimulation Over Prefrontal Cortex

“…Although many studies have investigated the neural mechanisms of TMS over the PFC in depression, however, results are not always consistent and a clear picture has yet to emerge. High-frequency rTMS applied over the left dlPFC protects against the development of negative mood symptoms and increases the susceptibility to negative emotional stimuli ( Möbius et al, 2016 ). High-frequency rTMS (10 Hz) over the left dlPFC of the depressed patients can improve the overall mood status, bias attentional processing toward negative information, and improve the Hamilton depression rating scale ( Leyman et al, 2011 ).…”