An analysis of functional neuroimaging studies of dorsolateral prefrontal cortical activity in depression.
Repetitive transcranial magnetic stimulation (rTMS) is currently undergoing active investigation for use in the treatment of major depression. Recent research has indicated that current methods used to localize the site of stimulation in dorsolateral prefrontal cortex (DLPFC) are significantly inaccurate. However, little information is available on which to base a choice of stimulation site. The aim of the current study was to systematically examine imaging studies in depression to attempt to identify whether there is a pattern of imaging results that suggests an optimal site of stimulation localization. We analysed all imaging studies published prior to 2005 that examined patients with major depression. Studies reporting activation in DLPFC were identified. The DLPFC regions identified in these studies were analysed using the Talairach and Rajkowska-Goldman-Rakic coordinate systems. In addition, we conducted a quantitative meta-analysis of resting studies and studies of serotonin reuptake inhibitor antidepressant treatment. There was considerable heterogeneity in the results between studies. Changes in Brodmann area 9 were relatively consistently identified in resting, cognitive activation and treatment studies included in the meta-analysis. However, there was little consistency in the direction of these changes or the hemisphere in which they were identified. At this stage, the results of imaging studies published to date have limited capacity to inform the choice of optimal prefrontal cortical region for the use in rTMS treatment studies.
Fitzgerald
Paul B
PB
Alfred Psychiatry Research Centre, The Alfred and Monash University, Department of Psychological Medicine, Melbourne, Victoria 3004, Australia. paul.fitzgerald@med.monash.edu.au
Oxley
Tom J
TJ
Laird
Angela R
AR
Kulkarni
Jayashri
J
Egan
Gary F
GF
Daskalakis
Zafiris J
ZJ
D000928:Antidepressive Agents / Q000627:therapeutic use; D001931:Brain Mapping; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000187:drug effects / Q000503:physiopathology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors