Repetitive transcranial magnetic stimulation promotes response inhibition in patients with major depression during the stop-signal task. (July 2022)

• Record Type: Journal Article
• Authors: Yu, Fengqiong; Huang, Yunheng; Chen, Tingting; Wang, Xin; Guo, Yaru; Fang, Ya; He, Kongliang; Zhu, Chunyan; Wang, Kai; Zhang, Lei
• Is Part Of: Journal of psychiatric research. Volume 151(2022)
• Page Start: 427
• Page End: 438
• Publication Date: 2022-07
• Subjects: Depression -- Response inhibition -- rTMS -- N2 -- P3 -- Theta oscillation; MDD major depressive disorder -- RI response inhibition -- lDLPFC left dorsolateral prefrontal cortex -- TMS transcranial magnetic stimulation -- ERPs event related potentials -- DBS deep brain stimulation -- NAcc nucleus accumbens -- HAMD Hamilton Depression Rating Scale -- HAMA Hamilton Anxiety Rating Scale -- rTMS repetitive transcranial magnetic stimulation -- SST stop-signal task -- SSTs successful stop trails -- GTs Go trails -- EROs event-related oscillations -- EEG electroencephalography -- ERSP event-relatedspectral perturbation analysis -- ITC inter-trial coherence -- RT-ANOVA repeated measures of variance -- Go RT reaction times to Go stimuli -- SSD stop signal delay -- SSRT stop-signal response time -- Go ACC accuracy of Go tasks -- Stop ACC accuracy of Stop tasks -- fMRI functional magnetic resonance imaging -- RMT resting motor threshold; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2022.05.014
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Background: Response inhibition (RI) deficit is an aspect of cognitive impairment in depressed individuals, but currently no effective treatment has been established. This study aimed to explore the effect of individualized repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (lDLPFC)-nucleus accumbens (NAcc) network on RI in patients with major depressive disorder (MDD). Methods: Fourty-four patients diagnosed with MDD were randomized to receive 15 once-daily sessions of active (10 Hz, 100% of resting motor threshold) or sham rTMS within a double-blind, sham-controlled trial. We measured the efficacy of rTMS by the improvements in behavioral and neurological manifestations during the stop-signal task. The Hamilton Depression Rating Scale-17 items (HAMD-17) was used to assess depressive symptoms. We analyzed the differences in RI performance between MDD patients and 30 healthy controls (HCs) at baseline and assessed whether MDD patients who completed rTMS treatment had comparable RI ability to HCs. Results: At baseline, the depressed patients showed longer stop-signal response time (SSRT), smaller P3 amplitudes, and weaker theta-band power in successful stop trials (SSTs) than HCs. The active group exhibited RI ability comparable to that of HCs after rTMS treatment, but the improvements were not significant in the sham group. The active group showed significant remission in depression symptoms post-treatment compared to the sham group, and the changes in P3 amplitudes and theta-band power during SSTs were negatively correlated with the decrease of HAMD-17 scores. Conclusion: The depressed patients have impaired RI and treatment with the individualized rTMS protocol may be an effective approach. Highlights: The depressed patients showed impaired response inhibition during the stop signal task compared to healthy participants The clinical trial was conducted to investigate the effects of rTMS on impaired response inhibition in depressed patients The target of rTMS was located at the site of the strongest positive connection between the left NAcc and the left DLPFC The individualized rTMS protocol improved impaired response inhibition for depressed patients