title: Brain effects of TMS delivered over prefrontal cortex in depressed adults: role of stimulation frequency and coil-cortex distance.
abstract: Relative regional brain blood flow was measured in 23 clinically depressed adults by using ECD SPECT at baseline and again during actual prefrontal transcranial magnetic stimulation (TMS) following 5 daily sessions of TMS. TMS over prefrontal cortex caused increased activity in cortex directly under the stimulation (inversely correlated with distance from scalp to cortex) and decreased activity in remote regions (anterior cingulate and anterior temporal poles). High-frequency rTMS (20 Hz) caused more relative flow immediately below the TMS coil than did low-frequency rTMS (5 Hz). Confirming the hypotheses tested, repeated daily TMS over the prefrontal cortex in medication-free depressed adults appears to change both local and remote blood flow in a manner that may also depend on the frequency of stimulation and coil to outer cortex distance.
authors.affiliation: Brain Stimulation Laboratory, Functional Neuroimaging Research Division, Departments of Psychiatry, Radiology, and Neurology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. nahasz@musc.edu
authors.forename: Z
authors.initials: Z
authors.lastname: Nahas
authors.forename: C C
authors.initials: CC
authors.lastname: Teneback
authors.forename: A
authors.initials: A
authors.lastname: Kozel
authors.forename: A M
authors.initials: AM
authors.lastname: Speer
authors.forename: C
authors.initials: C
authors.lastname: DeBrux
authors.forename: M
authors.initials: M
authors.lastname: Molloy
authors.forename: L
authors.initials: L
authors.lastname: Stallings
authors.forename: K M
authors.initials: KM
authors.lastname: Spicer
authors.forename: G
authors.initials: G
authors.lastname: Arana
authors.forename: D E
authors.initials: DE
authors.lastname: Bohning
authors.forename: S C
authors.initials: SC
authors.lastname: Risch
authors.forename: M S
authors.initials: MS
authors.lastname: George
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D004292:Dominance, Cerebral / Q000502:physiology; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D004574:Electromagnetic Fields; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome