Daily prefrontal closed-loop repetitive transcranial magnetic stimulation (rTMS) produces progressive EEG quasi-alpha phase entrainment in depressed adults.
Daily prefrontal closed-loop repetitive transcranial magnetic stimulation (rTMS) produces progressive EEG quasi-alpha phase entrainment in depressed adults.
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每日前额叶闭合回路重复经颅磁刺激（rTMS）在抑郁成年人中产生渐进性EEG准α相夹带。
DOI：
10.1016/j.brs.2022.02.008
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发表时间：
2022-03
影响因子：
7.7
通讯作者：
Sajda P
中科院分区：
文献类型：
--
作者：
Faller J;Doose J;Sun X;Mclntosh JR;Saber GT;Lin Y;Teves JB;Blankenship A;Huffman S;Goldman RI;George MS;Brown TR;Sajda P
经颅磁刺激（TMS）是一种非侵入性神经调节方式，可以治疗抑郁症，强迫症或帮助戒烟。研究表明，相对于内源性大脑状态，TMS的递送时间可能会影响疗效和短期大脑动力学。研究重复性经颅磁刺激（rTMS）的多周每日治疗是否对脑动力学产生影响，该影响取决于TMS相对于个体前额叶EEG准α节律（6至13 Hz）的时间。我们开发了一种新的闭环系统，为正在接受重度抑郁症治疗的患者提供个性化的EEG触发rTMS。在一项双盲研究中，患者在六周的时间内每天接受rTMS治疗，并被随机分配到同步或非同步治疗组，其中rTMS的同步是他们的前额叶EEG准α节律。当rTMS应用于背外侧前额叶皮层（DLPFC）并与患者的前额叶准α节律同步时，患者在刺激部位以及刺激部位远端区域的子集上在数周的时间内产生强烈的相位夹带。此外，在治疗过程结束时，该组的夹带相位移动到更接近最佳地接合远端目标的相位，即前扣带皮层（ACC）。在给予rTMS而没有每个TMS序列的初始EEG同步的组中没有观察到这些夹带效应。夹带效应在数天/数周的过程中建立，这表明这些效应涉及神经可塑性变化，这可能对抑郁症或其他疾病产生临床后果。
Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation modality that can treat depression, obsessive-compulsive disorder, or help smoking cessation. Research suggests that timing the delivery of TMS relative to an endogenous brain state may affect efficacy and short-term brain dynamics. To investigate whether, for a multi-week daily treatment of repetitive TMS (rTMS), there is an effect on brain dynamics that depends on the timing of the TMS relative to individuals’ prefrontal EEG quasi-alpha rhythm (between 6 to 13 Hz). We developed a novel closed-loop system that delivers personalized EEG-triggered rTMS to patients undergoing treatment for major depressive disorder. In a double blind study, patients received daily treatments of rTMS over a period of six weeks and were randomly assigned to either a synchronized or unsynchronized treatment group, where synchronization of rTMS was to their prefrontal EEG quasi-alpha rhythm. When rTMS is applied over the dorsal lateral prefrontal cortex (DLPFC) and synchronized to the patient’s prefrontal quasi-alpha rhythm, patients develop strong phase entrainment over a period of weeks, both over the stimulation site as well as in a subset of areas distal to the stimulation site. In addition, at the end of the course of treatment, this group’s entrainment phase shifts to be closer to the phase that optimally engages the distal target, namely the anterior cingulate cortex (ACC). These entrainment effects are not observed in the group that is given rTMS without initial EEG synchronization of each TMS train. The entrainment effects build over the course of days/weeks, suggesting that these effects engage neuroplastic changes which may have clinical consequences in depression or other diseases.
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影响因子：
5.3
作者：
Busch, Niko A.;Dubois, Julien;VanRullen, Rufin
通讯作者：
VanRullen, Rufin
影响因子：
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作者：
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通讯作者：
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影响因子：
19.9
作者：
Klimesch, Wolfgang
通讯作者：
Klimesch, Wolfgang