MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder

Katharine Dunlop; Pauline Gaprielian; Daniel Blumberger; Zafiris J. Daskalakis; Sidney H. Kennedy; Peter Giacobbe; Jonathan Downar

doi:10.3791/53129

Guiada por MRI dmPFC-EMTr como um tratamento para o Transtorno Depressivo Maior resistente ao tra...

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MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder

Guiada por MRI dmPFC-EMTr como um tratamento para o Transtorno Depressivo Maior resistente ao tratamento

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08:20 min

August 11, 2015

DOI: 10.3791/53129-v

Katharine Dunlop¹, Pauline Gaprielian⁶, Daniel Blumberger^5,7, Zafiris J. Daskalakis^5,7, Sidney H. Kennedy^2,3,5, Peter Giacobbe^2,3,5, Jonathan Downar^2,3,4,5

¹Institute of Medical Sciences,University of Toronto, ²MRI-Guided rTMS Clinic,University Health Network, ³Department of Psychiatry,University Health Network, ⁴Toronto Western Research Institute,University Health Network, ⁵Department of Psychiatry,University of Toronto, ⁶Faculty of Arts and Science,University of Toronto, ⁷Temerty Centre for Therapeutic Brain Intervention,Centre for Addiction and Mental Health

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Overview

This article outlines the procedure for MRI-guided repetitive transcranial magnetic stimulation (rTMS) targeting the dorsomedial prefrontal cortex as a treatment for major depressive disorder. The study demonstrates the effectiveness of this method in reducing depressive symptoms.

Key Study Components

Area of Science

Neuroscience
Psychiatry
Clinical Research

Background

Major depressive disorder is a prevalent mental health condition.
Repetitive transcranial magnetic stimulation is a non-invasive treatment option.
Targeting specific brain regions can enhance treatment efficacy.
Real-time neuronavigation improves the accuracy of stimulation.

Purpose of Study

To evaluate the effectiveness of rTMS on the dorsomedial prefrontal cortex.
To assess the reduction of depressive symptoms in patients.
To explore the potential of rTMS as a therapeutic intervention for major depression.

Methods Used

Acquisition of anatomical MRI for real-time neuronavigation.
Assessment of resting motor threshold to determine stimulation intensity.
Application of rTMS to the dorsomedial prefrontal cortex.
Evaluation of treatment outcomes using self-reported and clinical questionnaires.

Main Results

Significant reduction in depressive severity observed in pilot studies.
Positive outcomes reported through various assessment tools.
rTMS demonstrated as a viable treatment option for major depression.
Findings support further research into the mechanisms of depression.

Conclusions

rTMS is effective in reducing symptoms of major depressive disorder.
The method shows promise for future clinical applications.
Further studies are needed to explore long-term effects and mechanisms.

Frequently Asked Questions

What is rTMS?

Repetitive transcranial magnetic stimulation is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain.

How does rTMS help with depression?

rTMS targets specific areas of the brain involved in mood regulation, which can help alleviate symptoms of depression.

Is rTMS safe?

Yes, rTMS is generally considered safe with minimal side effects, making it a suitable option for many patients.

How long does an rTMS session last?

Each rTMS session typically lasts about 20 to 40 minutes, depending on the treatment protocol.

How many rTMS sessions are needed?

The number of sessions varies by individual, but a common treatment course may involve daily sessions over several weeks.

Can rTMS be combined with other treatments?

Yes, rTMS can be used alongside other treatments for depression, such as medication and psychotherapy.

Aqui descrevemos o procedimento para estimulação magnética transcraniana repetitiva guiada por ressonância magnética para o córtex pré-frontal dorsomedial como um tratamento experimental para transtorno depressivo maior.

O objetivo geral do experimento a seguir é estimular o córtex pré-frontal medial dorsal usando estimulação magnética transcraniana repetitiva ou RTMS como tratamento para depressão maior. Isso é conseguido adquirindo primeiro uma ressonância magnética anatômica para neuronavegação em tempo real durante a estimulação. Como segunda etapa, o limiar motor de repouso é avaliado, o que identifica a intensidade de estimulação do paciente para o tratamento da EMTR.

Em seguida, a EMTR é realizada no DMFC para reduzir a gravidade da depressão. Os resultados mostram uma redução significativa da gravidade depressiva em estudos-piloto abertos baseados em questionários auto-relatados e administrados clinicamente para depressão. Assim, o método de simulação magnética transcraniana repetitiva medial ou M-P-F-C-R-T-M-S é mais comumente usado para o tratamento da depressão maior e para a pesquisa dos mecanismos básicos da depressão maior.

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Medicina Edição 102 Neuroscience Ressonância Magnética (MRI) Guiado Estimulação Magnética Transcraniana repetitiva (EMTr) dorsomedial córtex pré-frontal (dmPFC) Transtorno Depressivo Maior (MDD)