Identification of reproducible individualized targets for treatment of depression with TMS based on intrinsic connectivity.
Identification of reproducible individualized targets for treatment of depression with TMS based on intrinsic connectivity.
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DOI：
10.1016/j.neuroimage.2012.10.082
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发表时间：
2013-02-01
期刊：
影响因子：
5.7
通讯作者：
Pascual-Leone A
中科院分区：
文献类型：
--
作者：
Fox MD;Liu H;Pascual-Leone A
经颅磁刺激（TMS）左背外侧前额叶皮层（DLPFC）在临床上用于治疗抑郁症，但结果差异很大。我们已经表明，不同的左DLPFC TMS网站的平均临床疗效与内在的功能连接与远程地区，包括膝下扣带回，并建议这些远程地区的功能连接可能会被用来确定优化的左DLPFC TMS的目标。然而，目前尚不清楚这种基于连接性的靶向方法是否以及如何应用于单个受试者水平，以潜在地对特定患者进行个性化治疗。在这篇文章中，我们表明，DLPFC连接的个体差异很大，可重复的会话，并可用于生成个性化的DLPFC TMS目标，可能证明临床上优于那些选择的基础上组平均连接上级。可能提高个性化的目标，包括使用种子地图和刺激的焦点的因素进行了调查和讨论。这里提出的技术可能适用于在一系列疾病和刺激模式中的局灶性脑刺激的个体化靶向，并且可以在临床试验中进行实验测试。
Transcranial magnetic stimulation (TMS) to the left dorsolateral prefrontal cortex (DLPFC) is used clinically for the treatment of depression however outcomes vary greatly between patients. We have shown that average clinical efficacy of different left DLPFC TMS sites is related to intrinsic functional connectivity with remote regions including the subgenual cingulate and suggested that functional connectivity with these remote regions might be used to identify optimized left DLPFC targets for TMS. However it remains unclear if and how this connectivity-based targeting approach should be applied at the single-subject level to potentially individualize therapy to specific patients. In this article we show that individual differences in DLPFC connectivity are large, reproducible across sessions, and can be used to generate individualized DLPFC TMS targets that may prove clinically superior to those selected on the basis of group-average connectivity. Factors likely to improve individualized targeting including the use of seed maps and the focality of stimulation are investigated and discussed. The techniques presented here may be applicable to individualized targeting of focal brain stimulation across a range of diseases and stimulation modalities and can be experimentally tested in clinical trials.
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DOI：
10.1073/pnas.0504136102
发表时间：
2005-07-05
影响因子：
11.1
作者：
Fox, MD;Snyder, AZ;Raichle, ME
通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
2010-03-01
影响因子：
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作者：
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通讯作者：
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DOI：
10.1073/pnas.1113148109
发表时间：
2012-02-28
影响因子：
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作者：
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