TMS-EEG investigation of prefrontal cortical excitability in depression and rTMS treatment response

项目总结 重度抑郁障碍(MDD)的治疗是一个严峻的临床挑战，因为近50%的抑郁症患者 患者对治疗没有完全反应，称为难治性抑郁症(TRD)。当前 抗抑郁药物需要几周的时间才能起作用，而且，目前还没有可靠的临床生物标记物可用于预测 治疗反应，导致不同治疗策略的几次反复尝试。两个人 MDD研究的主要挑战是-(I)开发更好的治疗方法和(Ii)开发非侵入性 临床上有用的抗抑郁治疗反应的生物标志物。这一奖项的主要目的是 研究前额叶皮质兴奋性作为抑郁和抑郁的神经生物学机制 同步经颅磁刺激rTMS对TRD患者的抗抑郁作用 脑电图仪(TMS-EEG)。该项目使用了一种创新的研究策略，通过部署TMS-EEG TRD患者基础状态和间歇状态下背外侧前额叶皮质兴奋性的研究 西塔爆发刺激(ITBS)是FDA批准的一种最先进的TRD治疗方法。对于基准比较： 人口统计学上匹配的健康对照组的患者将进行TMS-EEG。项目目标将会实现。 方法：1)研究抑郁症患者与健康对照组的前额叶皮质兴奋性。 受试者；2)调查ITBS对前额叶皮质兴奋性的影响；3)调查基线 慢性阻塞性肺疾病患者背外侧前额叶皮质兴奋性测定及其与情绪改善的关系 TRD。这项研究的发现将加强我们对抗抑郁剂潜在机制的理解 从而促进ITBS抗抑郁反应的非侵入性替代标记物的开发 TRD。这项工作将有助于：1)通过建立治疗标记物，在MDD中实现个性化用药 反应，2)了解rTMS的抗抑郁作用。

PROJECT SUMMARY Treatment of Major Depressive Disorder (MDD) is a serious clinical challenge as nearly 50% of depressed patients do not fully respond to treatment, referred to as Treatment Resistant Depression (TRD). Current antidepressants take few weeks to work and further, there are no reliable clinical biomarkers available to predict treatment response which leads to several trial-and-error attempts of different treatment strategies. The two leading challenges in MDD research are – (i) developing better treatments and (ii) developing noninvasive clinically useful biomarkers of antidepressant treatment response. The main objective of this award is to investigate prefrontal cortical excitability as neurobiological mechanisms underlying depression and antidepressant effect of rTMS in patients with TRD by using concurrent Transcranial Magnetic Stimulation- Electroencephalography (TMS-EEG). This project uses an innovative research strategy by deploying TMS-EEG to study cortical excitability in dorsolateral prefrontal cortex in TRD patients at baseline and after intermittent theta burst stimulation (iTBS), a state-of-the-art FDA approved TRD treatment. For baseline comparison with patients, demographically matched healthy controls will have TMS-EEG. The project aims will be accomplished by: 1) Investigating the prefrontal cortical excitability in patients with depression compared with healthy control subjects; 2) Investigating the effect of iTBS on prefrontal cortical excitability; and 3) Investigating the baseline dorsolateral prefrontal cortical excitability measures and its relationship to improvements in mood in patients with TRD. The findings from this study will strengthen our understanding of mechanisms underlying anti-depressant action and thus facilitate development of non-invasive surrogate markers of antidepressant response to iTBS in TRD. This work will contribute to: 1) personalized medicine in MDD by establishing markers of treatment response, 2) understanding rTMS antidepressant effect.