Subgenual Cingulate Theta Activity Predicts Treatment Response of Repetitive Transcranial Magnetic Stimulation in Participants With Vascular Depression

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression. Increased metabolism in the anterior cingulate cortex (ACC) is a known predictor for antidepressant response. The authors assessed whether increased theta power within the ACC predicts rTMS response in participants with vascular depression. Sixty-five participants were randomized to active or sham rTMS. Outcome was assessed using the Hamilton Depression Rating Scale. Electroencephalography was obtained, and comparisons were made among each group with a normative database using low-resolution electromagnetic tomography. Results suggest that vascular depression participants respond well to rTMS and that increased low-theta power in the subgenual ACC predicts response to rTMS.

Personalized Medicine: Review and Perspectives of Promising Baseline EEG Biomarkers in Major Depressive Disorder and Attention Deficit Hyperactivity Disorder

“…This suggests these two types of theta activity could have different implications and different origins. In line with Spronk et al [109], several studies have indeed shown low theta activity localized to the ACC, as estimated by source localization techniques, to respond worse to various antidepressant treatments [110,111,112,113]. These findings are in line with positron emission tomography and functional magnetic resonance imaging studies demonstrating low metabolic activity in the ACC is associated with worse treatment outcome; see also Pizzagalli [114] for an excellent review and meta-analysis on the rostral ACC (rACC) and treatment outcome.…”

Biological Markers in Noninvasive Brain Stimulation Trials in Major Depressive Disorder

“…Due to the detailed information that EEG provides on cortical brain oscillations that is different than fMRI, which only detects a change as compared to a previous time point, EEG has been used also to predict patients who may be responders to TMS treatment. Narushima et al [45], using a LORETA technique, identified that increased low-theta power in the subgenual anterior cingulated cortex was associated with antidepressant response, suggesting that EEG could be used as a predictor for antidepressant response to rTMS among patients with treatment-resistant vascular depression. Arns et al also stated a marker of positive response to TMS application by using EEG.…”

Motor cortex excitability in vascular depression

“…Until now, TMS studies conducted on elderly patients with VD concern the efficacy and safety of rTMS applied to the dorsolateral prefrontal cortex for the treatment of depressive symptoms (Fabre et al, 2004;Jorge et al, 2008), which is known to be more chronic and treatment-resistant than early-onset depression. The increased low theta power in the subgenual anterior cingulate cortex predicts antidepressant efficacy of rTMS probably due to current spread from dorsolateral prefrontal cortex to neighboring areas connected to the subgenual anterior cingulate cortex (Narushima et al, 2010).…”