title: Neural correlates of clinical improvement after deep transcranial magnetic stimulation (DTMS) for treatment-resistant depression: a case report using functional magnetic resonance imaging.
abstract: We report the effects of a 4-week trial of deep transcranial magnetic stimulation (DTMS) on depressive and anxious symptoms and brain activity in a patient (Mrs A) with treatment-resistant depression (TRD). The protocol involved a pre- and a post-functional magnetic resonance imaging (fMRI) scan during which Mrs A had to perform a working memory task (i.e., n-back). Her baseline score on the 21-item Hamilton Depression Rating Scale (HAM-D21) was 24, indicating severe depressive symptoms. Immediately after 4 weeks of daily DTMS treatment applied over the left dorsolateral prefrontal cortex (DLPFC), her HAM-D21 score decreased to 13 (a 46% reduction), and 1 month later, it was 12 (a 50% reduction). Moreover, Mrs A's accuracy scores on the n-back task (i.e., 2-back condition) improved from 79% (baseline) to 96% (after DTMS treatment). At the neural level, Mrs A showed significantly increased brain activity in the working memory network (e.g., DLPFC, parietal cortex) during the execution of the 2-back condition after DTMS treatment compared to baseline.
authors: a Department of Psychiatry , McGill University , Montreal , Quebec , Canada.
authors: Philippe-Olivier
authors: PO
authors: Harvey
authors: Frederique
authors: F
authors: Van den Eynde
authors: Abraham
authors: A
authors: Zangen
authors: Marcelo T
authors: MT
authors: Berlim
mesh_terms: D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D061218:Depressive Disorder, Treatment-Resistant / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology; D012720:Severity of Illness Index; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome
keywords: deep transcranial magnetic stimulation; functional magnetic resonance imaging; major depressive disorder; n-back task; working memory