Subgenual cingulate connectivity and hippocampal activation are related to MST therapeutic and adverse effects.
Subgenual cingulate connectivity and hippocampal activation are related to MST therapeutic and adverse effects.
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亚果实的连通性和海马激活与MST治疗和不良反应有关。
DOI：
10.1038/s41398-020-01042-7
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发表时间：
2020-11-10
影响因子：
6.8
通讯作者：
Daskalakis ZJ
中科院分区：
文献类型：
--
作者：
Hadas I;Zomorrodi R;Hill AT;Sun Y;Fitzgerald PB;Blumberger DM;Daskalakis ZJ
背外侧前额叶皮层（DLPFC）和膝下扣带皮层（SGC）之间的异常连接与抑郁症的病理生理学有关。间接证据也将海马激活与癫痫治疗的认知副作用联系起来。磁惊厥疗法是治疗难治性抑郁症的一种新方法。我们将联合收割机经颅磁刺激与脑电图（TMS-EEG）相结合，评价MST对TRD患者DLPFC、SGC和海马（Hipp）之间连接和激活的影响。在MST治疗试验之前和之后从31名TRD患者收集TMS-EEG。通过TMS-EEG方法，我们评估了显著电流散射（SCS）作为SGC和左侧DLPFC之间有效连接的指标。显著电流密度（SCD）用于评估Hipp水平的活性。在MST过程后，SGC和DLPFC之间的SCS减小（p < 0.036）。DLPFC-SGC有效连接减少与治疗前后汉密尔顿抑郁评分的变化相关（R = 0.46; p < 0.031）。在MST过程后，位于Hipp的SCD减少（p < 0.015），SCD变化与MST过程前后的蒙特利尔认知评估（莫卡）评分相关（R =-0.59; p < 0.026）。我们的研究结果表明，MST治疗与SGC-DLPFC连接减少有关，认知变化与Hipp激活减少有关。这些发现证明了两个不同的过程，分别驱动疗效和副作用，并可能最终有助于在临床环境中描绘生理TRD目标。
Aberrant connectivity between the dorsolateral prefrontal cortex (DLPFC) and the subgenual cingulate cortex (SGC) has been linked to the pathophysiology of depression. Indirect evidence also links hippocampal activation to the cognitive side effects of seizure treatments. Magnetic seizure therapy (MST) is a novel treatment for patients with treatment resistant depression (TRD). Here we combine transcranial magnetic stimulation with electroencephalography (TMS-EEG) to evaluate the effects of MST on connectivity and activation between the DLPFC, the SGC and hippocampus (Hipp) in patients with TRD. The TMS-EEG was collected from 31 TRD patients prior to and after an MST treatment trial. Through TMS-EEG methodology we evaluated significant current scattering (SCS) as an index of effective connectivity between the SGC and left DLPFC. Significant current density (SCD) was used to assess activity at the level of the Hipp. The SCS between the SGC and DLPFC was reduced after the course of MST (p < 0.036). The DLPFC-SGC effective connectivity reduction correlated with the changes in Hamilton depression score pre-to-post treatment (R = 0.46; p < 0.031). The SCD localized to the Hipp was reduced after the course of MST (p < 0.015), and the SCD change was correlated with montreal cognitive assessment (MOCA) scores pre-post the course of MST (R = −0.59; p < 0.026). Our findings suggest that MST treatment is associated with SGC-DLPFC connectivity reduction and that changes to cognition are associated with Hipp activation reduction. These findings demonstrate two distinct processes which drive efficacy and side effects separately, and might eventually aid in delineating physiological TRD targets in clinical settings.
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影响因子：
3.7
作者：
Attal Y;Schwartz D
通讯作者：
Schwartz D
影响因子：
6.8
作者：
Argyelan M;Lencz T;Kaliora S;Sarpal DK;Weissman N;Kingsley PB;Malhotra AK;Petrides G
通讯作者：
Petrides G
影响因子：
82.9
作者：
Drysdale AT;Grosenick L;Downar J;Dunlop K;Mansouri F;Meng Y;Fetcho RN;Zebley B;Oathes DJ;Etkin A;Schatzberg AF;Sudheimer K;Keller J;Mayberg HS;Gunning FM;Alexopoulos GS;Fox MD;Pascual-Leone A;Voss HU;Casey BJ;Dubin MJ;Liston C
通讯作者：
Liston C
影响因子：
7.4
作者：
Fitzgerald, Paul B.;Hoy, Kate E.;Daskalakis, Zafiris J.
通讯作者：
Daskalakis, Zafiris J.
影响因子：
5.7
作者：
Casali, Adenauer G.;Casarotto, Silvia;Massimini, Marcello
通讯作者：
Massimini, Marcello