Abstract
Background
Focal prefrontal cortex repetitive transcranial magnetic stimulation (rTMS) was originally
investigated as a potential antidepressant under the assumption that in depressed
patients, prefrontal cortex stimulation would produce changes in connected limbic
regions involved in mood regulation.
Methods
Fourteen adult patients with depression were scanned in a 1.5-T scanner using interleaved
rTMS (1 Hz) applied on the left prefrontal cortex over 7.35 min. Images were analyzed
with Statistical Parametric Mapping 2b and principal component analysis.
Results
Over the left prefrontal cortex, 1-Hz TMS was associated with increased activity at
the site of stimulation as well as in connected limbic regions: bilateral middle prefrontal
cortex, right orbital frontal cortex, left hippocampus, mediodorsal nucleus of the
thalamus, bilateral putamen, pulvinar, and insula (t = 3.85, p < .001). Significant deactivation was found in the right ventromedial frontal cortex.
Conclusions
In depressed patients, 1-Hz TMS at 100% motor threshold over the left prefrontal cortex
induces activation underneath the coil, activates frontal–subcortical neuronal circuits,
and decreases activity in the right ventromedial cortex. Further work is needed to
understand whether these immediate changes vary as a function of TMS use parameters
(intensity, frequency, location) and whether they relate to neurobiologic effects
and antidepressant mechanisms of TMS.
Keywords
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Article info
Publication history
Accepted:
January 13,
2004
Received in revised form:
January 7,
2004
Received:
October 9,
2003
Identification
Copyright
© 2004 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
