Advertisement

Identification of Personalized Transcranial Magnetic Stimulation Targets Based on Subgenual Cingulate Connectivity: An Independent Replication

  • Shan H. Siddiqi
    Correspondence
    Address correspondence to Shan H. Siddiqi, M.D.
    Affiliations
    Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, Massachusetts

    Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    Search for articles by this author
  • Anne Weigand
    Affiliations
    Department of Psychology, Humboldt University, Berlin, Germany
    Search for articles by this author
  • Alvaro Pascual-Leone
    Affiliations
    Department of Neurology, Harvard Medical School, Boston, Massachusetts

    Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts

    Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, Massachusetts
    Search for articles by this author
  • Michael D. Fox
    Affiliations
    Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, Massachusetts

    Department of Psychiatry, Harvard Medical School, Boston, Massachusetts

    Department of Neurology, Harvard Medical School, Boston, Massachusetts
    Search for articles by this author
      Transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (DLPFC) is commonly used to treat major depressive disorder. The most effective TMS targets are the DLPFC regions that are functionally anticorrelated with the subgenual cingulate (SGC) at the group level (
      • Weigand A.
      • Horn A.
      • Caballero R.
      • Cooke D.
      • Stern A.P.
      • Taylor S.F.
      • et al.
      Prospective validation that subgenual connectivity predicts antidepressant efficacy of transcranial magnetic stimulation sites.
      ,
      • Fox M.D.
      • Buckner R.L.
      • White M.P.
      • Greicius M.D.
      • Pascual-Leone A.
      Efficacy of transcranial magnetic stimulation targets for depression is related to intrinsic functional connectivity with the subgenual cingulate.
      ,
      • Cash R.F.H.
      • Zalesky A.
      • Thomson R.H.
      • Tian Y.
      • Cocchi L.
      • Fitzgerald P.B.
      Subgenual functional connectivity predicts antidepressant treatment response to transcranial magnetic stimulation: Independent validation and evaluation of personalization.
      ). Based on this finding, multiple studies have attempted to personalize TMS targets using individualized connectivity to the SGC (
      • Cole E.J.
      • Stimpson K.H.
      • Bentzley B.S.
      • Gulser M.
      • Cherian K.
      • Tischler C.
      • et al.
      Stanford Accelerated Intelligent Neuromodulation Therapy for treatment-resistant depression.
      ,
      • Ning L.
      • Makris N.
      • Camprodon J.A.
      • Rathi Y.
      Limits and reproducibility of resting-state functional MRI definition of DLPFC targets for neuromodulation.
      ,
      • Fox M.D.
      • Liu H.
      • Pascual-Leone A.
      Identification of reproducible individualized targets for treatment of depression with TMS based on intrinsic connectivity.
      ). In a recent retrospective study (N = 26), antidepressant efficacy of each TMS site was correlated with its proximity to this personalized target and its connectivity to the SGC (
      • Cash R.F.H.
      • Cocchi L.
      • Lv J.
      • Fitzgerald P.B.
      • Zalesky A.
      Functional magnetic resonance imaging–guided personalization of transcranial magnetic stimulation treatment for depression.
      ). However, this study was limited by relatively brief treatment course (3 weeks) and scan duration (6 minutes), which may limit the reproducibility of the results. We attempted to replicate this finding in 25 patients who received 6 weeks of TMS for major depressive disorder at an independent center.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Weigand A.
        • Horn A.
        • Caballero R.
        • Cooke D.
        • Stern A.P.
        • Taylor S.F.
        • et al.
        Prospective validation that subgenual connectivity predicts antidepressant efficacy of transcranial magnetic stimulation sites.
        Biol Psychiatry. 2018; 84: 28-37
        • Fox M.D.
        • Buckner R.L.
        • White M.P.
        • Greicius M.D.
        • Pascual-Leone A.
        Efficacy of transcranial magnetic stimulation targets for depression is related to intrinsic functional connectivity with the subgenual cingulate.
        Biol Psychiatry. 2012; 72: 595-603
        • Cash R.F.H.
        • Zalesky A.
        • Thomson R.H.
        • Tian Y.
        • Cocchi L.
        • Fitzgerald P.B.
        Subgenual functional connectivity predicts antidepressant treatment response to transcranial magnetic stimulation: Independent validation and evaluation of personalization.
        Biol Psychiatry. 2019; 86: e5-e7
        • Cole E.J.
        • Stimpson K.H.
        • Bentzley B.S.
        • Gulser M.
        • Cherian K.
        • Tischler C.
        • et al.
        Stanford Accelerated Intelligent Neuromodulation Therapy for treatment-resistant depression.
        Am J Psychiatry. 2020; 177: 716-726
        • Ning L.
        • Makris N.
        • Camprodon J.A.
        • Rathi Y.
        Limits and reproducibility of resting-state functional MRI definition of DLPFC targets for neuromodulation.
        Brain Stimul. 2019; 12: 129-138
        • Fox M.D.
        • Liu H.
        • Pascual-Leone A.
        Identification of reproducible individualized targets for treatment of depression with TMS based on intrinsic connectivity.
        Neuroimage. 2013; 66: 151-160
        • Cash R.F.H.
        • Cocchi L.
        • Lv J.
        • Fitzgerald P.B.
        • Zalesky A.
        Functional magnetic resonance imaging–guided personalization of transcranial magnetic stimulation treatment for depression.
        JAMA Psychiatry. 2021; 78: 337-339
        • Siddiqi S.H.
        • Trapp N.T.
        • Shahim P.
        • Hacker C.D.
        • Laumann T.O.
        • Kandala S.
        • et al.
        Individualized connectome-targeted transcranial magnetic stimulation for neuropsychiatric sequelae of repetitive traumatic brain injury in a retired NFL player.
        J Neuropsychiatry Clin Neurosci. 2019; 31: 254-263
        • Laumann T.O.
        • Gordon E.M.
        • Adeyemo B.
        • Snyder A.Z.
        • Joo S.J.
        • Chen M.Y.
        • et al.
        Functional system and areal organization of a highly sampled individual human brain.
        Neuron. 2015; 87: 657-670
        • Opitz A.
        • Fox M.D.
        • Craddock R.C.
        • Colcombe S.
        • Milham M.P.
        An integrated framework for targeting functional networks via transcranial magnetic stimulation.
        Neuroimage. 2016; 127: 86-96