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Baseline functional connectivity may predict placebo responses to accelerated rTMS treatment in major depression.

Authors
  • Wu, Guo-Rong1
  • Wang, Xiaowan1
  • Baeken, Chris2, 3, 4, 5
  • 1 Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China. , (China)
  • 2 Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium. , (Belgium)
  • 3 Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZBrussel), Brussels, Belgium. , (Belgium)
  • 4 Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium. , (Belgium)
  • 5 Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. , (Netherlands)
Type
Published Article
Journal
Human Brain Mapping
Publisher
Wiley (John Wiley & Sons)
Publication Date
Feb 15, 2020
Volume
41
Issue
3
Pages
632–639
Identifiers
DOI: 10.1002/hbm.24828
PMID: 31633261
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Although in theory sham repetitive transcranial magnetic stimulation (rTMS) has no inherent therapeutic value, nonetheless, such placebo stimulations may have relevant therapeutic effects in clinically depressed patients. On the other hand, antidepressant responses to sham rTMS are quite heterogeneous across individuals and its neural underpinnings have not been explored yet. The current brain imaging study aims to detect baseline neural fingerprints resulting in clinically beneficial placebo rTMS treatment responses. We collected resting-state functional magnetic resonance imaging data prior to a registered randomized clinical trial of accelerated placebo stimulation protocol in patients documented with treatment-resistant depression (http://clinicaltrials.gov/show/NCT01832805). In addition to global brain connectivity and rostral anterior cingulate cortex (rACC) seed-based functional connectivity (FC), elastic-net regression and cross-validation procedures were used to identify baseline intrinsic brain connectivity biomarkers for sham-rTMS responses. Placebo responses to accelerated sham rTMS were correlated with baseline global brain connectivity in the rACC/ventral medial prefrontal cortex (vmPFC). Concerning the rACC seed-based FC analysis, the placebo response was associated positively with the precuneus/posterior cingulate (PCun/PCC) cortex and negatively with the middle frontal gyrus. Our findings provide first brain imaging evidence for placebo responses to sham stimulation being predictable from rACC rsFC profiles, especially in brain areas implicated in (re)appraisal and self-focus processes. © 2019 The Authors. Human Brain Mapping published by Wiley Periodicals, Inc.

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