Evaluation of Transcranial Magnetic Stimulation Efficiency in Major Depressive Disorder Patients: A Magnetic Resonance Spectroscopy Study
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study evaluated the antidepressant effect of rTMS and examined how it affected N-asetyl aspartate (NAA), choline (Cho), creatine (Cr), lactate (Lac), myoinositol (mIns), glutamate (Glu), glutathione (GSH), and glutamine (Gln) metabolite levels in the left dorsolateral prefrontal cortex (DLPFC) of MDD patients who were not receiving antidepressant medication. Methods In total, 18 patients (10 female, 8 male) were evaluated. Each patient underwent H magnetic resonance spectroscopy (H-MRS) before and within 3 days of completion of TMS therapy. All patients completed 20 sessions of rTMS directed at the left DLPFC over a 2-week period. The Hamilton Depression Scale (HAMD) scores of patients were calculated, and their responses to treatment were assessed within 1–3 days of completion of TMS. Results We found statistically significant differences in HAMD scores before and after rTMS. Moreover, the peak metabolite ratios of NAA/Cr, GSH/Cr, and Gln/Cr were significantly higher after rTMS compared to those before rTMS. Conclusion Increased understanding of the mechanism of action of TMS will improve its application and may stimulate development of new-generation therapeutic agents.
Abstract
Objective Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study evaluated the antidepressant effect of rTMS and examined how it affected N-asetyl aspartate (NAA), choline (Cho), creatine (Cr), lactate (Lac), myoinositol (mIns), glutamate (Glu), glutathione (GSH), and glutamine (Gln) metabolite levels in the left dorsolateral prefrontal cortex (DLPFC) of MDD patients who were not receiving antidepressant medication. Methods In total, 18 patients (10 female, 8 male) were evaluated. Each patient underwent H magnetic resonance spectroscopy (H-MRS) before and within 3 days of completion of TMS therapy. All patients completed 20 sessions of rTMS directed at the left DLPFC over a 2-week period. The Hamilton Depression Scale (HAMD) scores of patients were calculated, and their responses to treatment were assessed within 1–3 days of completion of TMS. Results We found statistically significant differences in HAMD scores before and after rTMS. Moreover, the peak metabolite ratios of NAA/Cr, GSH/Cr, and Gln/Cr were significantly higher after rTMS compared to those before rTMS. Conclusion Increased understanding of the mechanism of action of TMS will improve its application and may stimulate development of new-generation therapeutic agents.
참고문헌 (43)
- Wagner T, "Biophysical foundations underlying TMS : setting the stage for an effective use of neurostimulation in the cognitive neurosciences", Cortex, 45, pp.1025~1034 (2009)
- George MS, "Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder : a sham-controlled randomized trial", Arch Gen Psychiatry, 67, pp.507~516 (2010)
- Blumberger DM, "Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression(THREE-D) : a randomised non-inferiority trial", Lancet, 391, pp.1683~1692 (2018)
- Pascual-Leone A, "Lateralized effect of rapid-rate rTMS of the prefrontal cortex on mood", Neurology, 46, pp.499~502 (1996)
- George MS, "Transcranial magnetic stimulation for the treatment of depression", Expert Rev Neurother, 10, pp.1761~1772 (2010)
- Pascual-Leoné A, "Rapid rate rTMS of left dorsolateral cortex in drug resistant depression", Lancet, 347, pp.233~237 (1996)
- Yadollahpour A, "rTMS for the treatment of depression : a comprehensive review of effective protocols on right DLPFC", Int J Ment Health Addict, 14, pp.539~549 (2016)
- Rodriguez-Martin JL, "Transcranial magnetic stimulation for treating depression", Cochrane Database Syst Rev, (2), pp.CD003493~ (2002)
- Fitzgerald PB, "The effects of repetitive transcranial magnetic stimulation in the treatment of depression", Expert Rev Med Devices, 8, pp.85~95 (2011)
- Zangen A, "Transcranial magnetic stimulation induces increases in extracellular levels of dopamine and glutamate in the nucleus accumbens", Neuroreport, 13, pp.2401~2405 (2002)
- Tkac I, "In vivo 1H NMR spectroscopy of the human brain at high magnetic fields: Metabolite quantification at 4T vs. 7T", Mag Reson Med, 62, pp.868~879 (2009)
- Hone-Blanchet A, "Co-registration of magnetic resonance spectroscopy and transcranial magnetic stimulation", J Neurosci Methods, 242, pp.52~57 (2015)
- Block W, "Proton MR spectroscopy of the hippocampus at 3 T in patients with unipolar major depressive disorder : correlates and predictors of treatment response", Int J Neuropsychopharmacol, 12, pp.415~422 (2009)
- Oğuzhanoğlu NK, "Prefrontal cortex neurochemical metabolite levels in major depression and the effects of treatment : An 1 H MRS study", Turk J Psychiatry, 25, pp.75~83 (2013)
- Cumurcu BE, "Evaluation of neuroprotective effects of lithium and olanzapine on brain tissue in bipolar affective disorder : a comperative study with MR spectroscopy", J Anatol Psychiatry, 5, pp.197~205 (2004)
- Speer AM, "Opposite effects of high and low frequency rTMS on regional brain activity in depressed patients", Biol Psychiatry, 48, pp.1133~1141 (2000)
- Padberg F, "Repetitive transcranial magnetic stimulation(rTMS)in major depression : Relation between efficacy and stimulation intensity", Neuropsychopharmacology, 27, pp.638~645 (2002)
- Salomons TV, "Resting-state corticothalamic-striatal connectivity predicts response to dorsomedial prefrontal rTMS in major depressive disorder", Neuropsychopharmacology, 39, pp.488~498 (2014)
- Dubin MJ, "Elevated prefrontal cortex GABA in patients with major depressive disorder after TMS treatment measured with proton magnetic resonance spectroscopy", J Psychiatry Neurosci, 41, pp.E37~ (2016)[DOI]
- Herwig U, "Using the international 10–20 EEG system for positioning of transcranial magnetic stimulation", Brain Topogr, 16, pp.95~99 (2003)
- Angelie E, "Regional differences and metabolic changes in normal aging of the human brain : Proton MR spectroscopic imaging study", Am J Neuroradiol, 22, pp.119~127 (2001)
- Koenigs M, "The functional neuroanatomy of depression : distinct roles for ventromedial and dorsolateral prefrontal cortex", Behav Brain Res, 201, pp.239~243 (2009)
- Wang Y, "Frontal white matter biochemical abnormalities in first-episode, treatment-naive patients with major depressive 61 disorder : a proton magnetic resonance spectroscopy study", J Affect Disord, 136, pp.620~626 (2012)
- Chen LP, "Anterior cingulate cortex and cerebellar hemisphere neurometabolite changes in depression treatment : A H magnetic resonance spectroscopy study", Psychiatry Clin Neurosci, 68, pp.357~364 (2014)
- Abdallah CG, "Decreased occipital cortical glutamate levels in response to successful cognitive behavioral therapy and pharmaco therapy for major depressive disorder", Psychother Psychosom, 83, pp.289~307 (2014)
- Vythilingam M, "Focal and lateralized subcortical abnormalities in unipolar major depressive disorder : an automated multivoxel proton magnetic resonance spectroscopy study", Biol Psychiatry, 54, pp.744~750 (2003)
- De Diego-Adelino J, "Hippocampal abnormalities of glutamate", glutamine, N-acetylaspartate and choline in patients with depression are related to a stillness burden, 2013, pp.38, 107~116
- Wu WE, "Whole brain N-acetylaspartate concentration is conserved throughout normal aging", Neurobiol Aging, 33, pp.2440~2447 (2012)
- Jia Y, "The correlation between biochemical abnormalities in frontal white matter, hippocampus and serum thyroid 76 hormone levels in first-episode patients with major depressive disorder", J Affect Disord, 180, pp.162~169 (2015)
- Moore GJ, "Lithium increases N-acetyl-aspartate in the human brain: in vivo evidence in support of bcl-2’s neurotrophic effects?", Biol Psychiatry, 48, pp.1~8 (2000)
- Sonawalla SB, "Compounds containing cytosolic choline in the basal ganglia : A potential biological marker of true drug response to fluoxetine", Am J Psychiatry, 156, pp.1638~1640 (1999)
- Auer DP, "Reduced glutamate in the anterior cingulate cortex in depression : an in vivo proton magnetic resonance spectroscopy study", Biol Psychiatry, 47, pp.305~313 (2000)
- Gönül AS, "The effect of antidepressant treatment on N-acetyl aspartate levels of medial frontal cortex in drug free depressed patients", Prog Neuropsychopharmacol Biol Psychiatry, 30, pp.120~125 (2006)
- Zhang Y, "A MRS study of metabolic alterations in the frontal white matter of major depressive disorder patients with the treatment of SSRIs", BMC Psychiatry, 15, pp.99~ (2015)
- Herman-Sucharska I, "Usefulness of proton MR spectroscopy for determining diagnosis and treatment outcome in unipolar depressive disorder", Przegl Lek, 67, pp.243~246 (2010)
- Son H, "Glutamine has antidepressive effects through increments of glutamate and glutamine levels and glutamatergic activity in the medial prefrontal cortex", Neuropharmacology, 25, pp.143~152 (2018)
- Lee Y, "Glutamine deficiency in the prefrontal cortex increases depressive-like behaviours in male mice", J Psychiatry Neurosci, 38, pp.183~191 (2013)
- Michael N, "Metabolic changes within the left dorsolateral prefrontal cortex occurring with electroconvulsive therapy in patients with treatment resistant unipolar depression", Psychol Med, 33, pp.1277~1284 (2003)
- Dringen R, "Metabolism and functions of glutathione in brain", Prog Neurobiol, 62, pp.649~671 (2000)
- Behr GA, "Preclinical and clinical evidence of antioxidant effects of antidepressant agents : implications for the pathophysiology of major depressive disorder", Oxid Med Cell Longev, 2012, pp.609421~ (2012)
- Bilici M, "Antioxidative enzyme activities and lipid peroxidation in major depression : alterations by antidepressant treatments", J Affect Disord, 64, pp.43~51 (2001)
- Magalhães PV, "N-acetyl cysteine add-on treatment for bipolar II disorder : a subgroup analysis of a randomized placebo-controlled trial", J Affect Disord, 129, pp.317~320 (2011)
- Slattery J, "Clinical trials of N-acetylcysteine in psychiatry and neurology : A systematic review", Neurosci Biobehav Rev, 55, pp.294~321 (2015)
