Pregenual or subgenual anterior cingulate cortex as potential effective region for brain stimulation of depression
Pregenual or subgenual anterior cingulate cortex as potential effective region for brain stimulation of depression
复制标题
膝前或膝下前扣带皮层作为抑郁症大脑刺激的潜在有效区域
DOI：
10.1002/brb3.1591
复制
发表时间：
2020-04-01
影响因子：
3.1
通讯作者：
Wang, Jue
中科院分区：
文献类型：
--
作者：
Jing, Ying;Zhao, Na;Wang, Jue
背景：背外侧前额叶皮质(DLPFC)是重复经颅磁刺激(RTMS)治疗重度抑郁症(MDD)的标准刺激靶点。Fox及其同事的一项回顾研究发现，在一大群健康参与者中，左侧DLPFC与膝下扣带前皮质(SgACC)之间更负的静息状态功能磁共振成像(RS-fMRI)功能连接(FC)与rTMS对MDD的更好疗效相关，这表明sgACC可能是一个有效区域。然而，最近一项关于RS-fMRI研究的Meta分析发现，MDD患者的前驱ACC(PgACC)而不是sgACC显示出局部活动增加。结果(A)pgACC和sgACC均与左侧DLPFC的rTMS-DLPFC呈负相关；(B)sgACC-DLPFC和pgACC-DLPFC反应者的FCS均较无反应者为负；(C)DLPFC-sgACC-sgACC功能连接性与临床疗效的关系集中在sgACC附近。结论pgACC和sgACC可能是左侧DLPFC的rTMS治疗MDD的潜在有效区域。但今后仍需进行基于ACC-DLPFC的个体化rTMS治疗抑郁症，以检验pgACC或sgACC是否为有效区域。
Background The dorsolateral prefrontal cortex (DLPFC) is the standard stimulation target for the repetitive transcranial magnetic stimulation (rTMS) treatment of major depression disorder (MDD). A retrospective study by Fox and colleagues found that a more negative resting-state functional magnetic resonance imaging (RS-fMRI) functional connectivity (FC) between left DLPFC and the subgenual anterior cingulate cortex (sgACC) in a large group of healthy participants is associated with a better curative effects of rTMS in MDD, suggesting that the sgACC may be an effective region. However, a recent meta-analysis on RS-fMRI studies found that the pregenual ACC (pgACC), rather than the sgACC, of MDD patients showed increased local activity.Methods We used the stimulation coordinates in the left DLPFC analyzed by Fox et al. to perform RS-fMRI FC between the stimulation targets obtained from previous rTMS MDD studies and the potential effective regions (sgACC and pgACC, respectively) on the RS-fMRI data from 88 heathy participants.Results (a) Both the pgACC and the sgACC were negatively connected to the left DLPFC; (b) both FCs of sgACC-DLPFC and pgACC-DLPFC were more negative in responders than in nonresponders; and (c) the associations between DLPFC-sgACC functional connectivity and clinical efficacy were clustered around the midline sgACC.Conclusions Both the pgACC and the sgACC may be potential effective regions for rTMS on the left DLPFC for treatment of MDD. However, individualized ACC-DLPFC FC-based rTMS on depression should be performed in the future to test the pgACC or the sgACC as effective regions.