The impact of accelerated high frequency rTMS on brain neurochemicals in treatment-resistant depression: Insights from 1H MR spectroscopy
The impact of accelerated high frequency rTMS on brain neurochemicals in treatment-resistant depression: Insights from 1H MR spectroscopy
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DOI：
10.1016/j.clinph.2017.06.243
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发表时间：
2017-09-01
影响因子：
4.7
通讯作者：
Van Schuerbeek, Peter
中科院分区：
文献类型：
--
作者：
Baeken, Chris;Lefaucheur, Jean-Pascal;Van Schuerbeek, Peter
目的：虽然加速重复经颅磁刺激（rTMS）设计似乎能够在相对较短的时间内缓解情绪，但尚未有研究检查神经化学物质在工作机制，安全性和神经完整性方面的细胞效应。&对位;&对位;方法：18名右撇子无抗抑郁单极治疗抵抗性抑郁症（TRD）患者参与了假对照加速高频(aHF)-rTMS H-1磁共振波谱研究，该研究应用于左背外侧前额叶皮层（DLPFC）。将基线测量值与18名年龄和性别匹配的健康对照进行比较。我们明确关注双侧DLPFC和吻侧前扣带皮层（rACC）的神经化学浓度。&对位;&对位;结果：与健康个体相比，TRD患者左侧DLPFC的基线谷氨酸-matergic（谷氨酸和谷氨酰胺的绝对浓度总和）浓度显著降低。aHF-rTMS并没有显著改变三个预定脑区的神经化学物质浓度。临床改善与左侧DLPFC中GABA浓度显著升高有关。&对位;&对位;结论：加速HF-rTMS治疗不会影响所检查区域的神经完整性。观察到的GABA浓度增加表明，aHF-rTMS的直接治疗效果可能是通过局部增加的GABA能抑制性神经传递来介导的。&对位;&对位;意义：虽然需要更多的统计能力才能得出确切的结论，但aHF-rTMS似乎并未对神经完整性产生负面影响。(C) 2017国际临床神经生理学联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: Although accelerated repetitive transcranial magnetic stimulation (rTMS) designs seem to be able to alleviate mood over a relatively short period of time, no studies yet examined the cellular effects on neurochemicals with regard to working mechanisms, safety and neural integrity.& para;& para;Methods: Eighteen right-handed antidepressant-free unipolar treatment resistant depressed (TRD) patients participated in this sham-controlled accelerated high frequency (aHF)-rTMS H-1 MR spectroscopy study applied to the left dorsolateral prefrontal cortex (DLPFC). Baseline measurements were compared to eighteen age- and gender-matched healthy controls. We explicitly focused on neurochemical concentrations in the bilateral DLPFC and rostral anterior cingulate cortex (rACC).& para;& para;Results: Compared to healthy individuals, TRD patients displayed significantly lower baseline gluta-matergic (sum absolute concentrations glutamate and glutamine) concentrations in the left DLPFC. aHF-rTMS does not significantly alter neurochemical concentrations in the three predefined brain regions. Clinical improvement was related to significant GABA concentration increases in the left DLPFC.& para;& para;Conclusions: Accelerated HF-rTMS treatment did not affect neural integrity in the examined regions. The observed GABA concentration increases suggest that the immediate therapeutic effects of aHF-rTMS could be mediated through a locally increased GABAergic inhibitory neurotransmission.& para;& para;Significance: Although more statistical power is needed for reaching firm conclusions, aHF-rTMS does not appear to negatively influence neural integrity. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.