FUNCTIONAL MRI IN PATIENTS WITH THERAPEUTICALLY RESISTANT DEPRESSION BEFORE AND AFTER TRANSCRANIAL MAGNETIC STIMULATION
Ustyuzhanin D.V.1, Rangus S.R.2, Usmanova I.I.3, Agliullina A.A.3,
Il’yasov K.A.3, Prosvetov A.O.2, Bakhtiozin R.F.4
1 - Chazov National Medical Research Center of Cardiology. Moscow, Russia.
2 - A.I. Yevdokimov Moscow State University of Medicine and Dentistry. Moscow, Russia.
3 - Kazan (Volga Region) Federal Univesity. Kazan, Russia.
4 - Sechenov University. Moscow, Russia.
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urpose. To evaluate the cerebral cortex activation changes in patients with therapeutically resistant depression (TRD) before and after treatment with transcranial magnetic stimulation (TMS).
Material and methods. The study included 10 patients with a confirmed diagnosis of TRD. The severity of depression by the Beck scale, resting state fMRI and task based fMRI with the face emotions recognition paradigm were evaluated in each patient before treatment and after 30 days of combined TMS and drug therapy.
Results. The average depression score by the Beck scale significantly decreased from 31.8± 2.6 to 12.2±5.8 before and after treatment, p<0.001. Complete remission was achieved in 7 patients. Task based fMRI showed a significant decrease in the frontal cortex activation zone when recognizing positive emotions after a course of treatment (the activation decreased from 1471 to 198 voxels, in the left Brodmann area 45 P<0.05; from 1017 to 184 voxels in the left Brodmann areas 44/6, P<0.05; the activation zone volume in the left Brodmann area 6 was 718 voxels before treatment, and it was not detected after treatment). When recognizing negative emotions, there was a decrease in the activation zone in the right frontal cortex, which included Brodmann areas 44, 45 and 6 (from 1087 to 209 voxels, P<0.05). Resting state fMRI demonstrated the functional connectivity of the left medial frontal gyrus with the left cingular gyrus and the default mode network in patients before treatment. After treatment, this functional connectivity effect decreased significantly.
Conclusions. The course of transcranial magnetic stimulation in patients with therapeutically resistant depression reduces the functional activity of the frontal cortex and also decreases the functional connectivity of the left medial frontal gyrus with the limbic system and the default mode network.
Keywords: fMRI, resting state fMRI, prefrontal cortex, depression, transcranial stimulation.
Corresponding author: Ustyuzhanin D.V. e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Ustyuzhanin D.V., Rangus S.R., Usmanova I.I., Agliullina A.A., Il’yasov K.A., Prosvetov A.O., Bakhtiozin R.F. Functional MRI in patients with therapeutically resistant depression before and after transcranial magnetic stimulation. REJR 2023; 13(2):24-37. DOI: 10.21569/2222-7415-2023-13-2-24-37.
Received: 06.05.23 Accepted: 05.06.23