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Personalized target selection for TMS therapy using functional vs. structural connectivity MRI

使用功能性与结构性连接 MRI 进行 TMS 治疗的个性化靶点选择

基本信息

批准号：
9433834
负责人：
Joan A Camprodon
金额：
$ 25.17万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-12-11 至 2019-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9433834
关键词：
Address Affect Anatomy Anisotropy Anterior Antidepressive Agents Clinical Clinical Data Corpus Callosum Corticospinal Tracts Data Data Analyses Data Set Databases Diffusion Diffusion Magnetic Resonance Imaging Disease remission Electromagnetics FDA approved Fiber Forcep Functional Magnetic Resonance Imaging Future Goals Grant Human Intervention Investigational Therapies Left Life Location Magnetic Resonance Imaging Major Depressive Disorder Measures Mental Depression Methodology Methods Modality Patients Physiologic pulse Precision therapeutics Prefrontal Cortex Property Refractory Reproducibility Rest Safety Scanning Thalamic structure Therapeutic Therapeutic Trials Time Tissues Transcranial magnetic stimulation Treatment Efficacy Ventral Striatum base brain tissue clinical efficacy cohort comparative connectome human subject image guided imaging modality improved individual patient multimodality neuropsychiatry novel strategies open label personalized approach precision medicine prospective response temporal measurement therapeutic target tractography treatment response white matter

项目摘要

Project Summary Title: Personalized target selection for TMS therapy using functional vs. structural connectivity MRI Transcranial magnetic stimulation (TMS) is an FDA-approved treatment for major depressive disorder (MDD). Remission rates are estimated to be around 30%, similar to other antidepressant therapies yet still suboptimal. A key reason for the variability in response is the lack of an individualized approach that identifies the cortical therapeutic target for each patient. A proposed strategy is to use functional connectivity MRI to identify the topography of functional networks relevant to MDD. In this project, we propose a novel strategy to personalized identification of TMS targets by using diffusion MRI (dMRI) to identify the white matter bundles that connect two critical nodes affected by MDD: the left prefrontal cortex (PFC) and the subgenual cingulate (SGC). We will study 500 subjects from the Human Connectome Project (HCP) and 20 patients with MDD who were treated with TMS. We will use state-of-the-art functional connectivity and diffusion MRI data and analyses. Our goal is to quantify and compare, for the first time, the reliability of these methods to identify cortical targets for TMS therapy. In addition we will study the clinical efficacy of dMRI-guided TMS by retrospectively analyzing the relationship between therapeutic response and location of the stimulated TMS target in relation to the optimal dMRI node. Last, we will use sophisticated dMRI metrics to assess the changes in white matter microstructure induced by TMS and how they relate to clinical efficacy (therefore defining anatomical mechanisms of action and therapeutic targets). Results from this project will support future prospective trials aiming to confirm target engagement and therapeutic response using individualized dMRI-guided TMS in MDD and other neuropsychiatric conditions.

项目总结