nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2022-4-12-19nnp-1855Research ArticleORIGINAL INVESTIGATIONSОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ И МЕТОДИКИStructural and functional biomarkers of the effect of navigational repetitive transcranial magnetic stimulation in patients with drug-resistant depressionСтруктурные и функциональные биомаркеры эффекта навигационной ритмической транскраниальной магнитной стимуляции у пациентов с фармакорезистентной депрессиейhttps://orcid.org/0000-0003-1841-1177ПойдашеваА. Г.PoydashevaA. G.

Александра Георгиевна Пойдашева125367, Москва, Волоколамское шоссе, 80

Alexandra Georgievna Poydasheva125367, Moscow, Volokolamskoe Sh., 80

alexandra.poydasheva@gmail.comhttps://orcid.org/0000-0001-9951-9803СиницынД. О.SinitsynD. O.

125367, Москва, Волоколамское шоссе, 80

125367, Moscow, Volokolamskoe Sh., 80

https://orcid.org/0000-0003-0716-3737БакулинИ. С.BakulinI. S.

125367, Москва, Волоколамское шоссе, 80

125367, Moscow, Volokolamskoe Sh., 80

https://orcid.org/0000-0003-3956-6362СупоневаН. А.SuponevaN. A.

125367, Москва, Волоколамское шоссе, 80

125367, Moscow, Volokolamskoe Sh., 80

https://orcid.org/0000-0002-6338-0392ПирадовМ. А.PiradovM. A.

125367, Москва, Волоколамское шоссе, 80

125367, Moscow, Volokolamskoe Sh., 80

Институт нейрореабилитации и восстановительных технологий ФГБНУ «Научный центр неврологии»РоссияInstitute of Neurorehabilitation and Restorative Technologies, Scientific Center of NeurologyRussian Federation2022200820221441219Copyright © Poydasheva A.G., Sinitsyn D.O., Bakulin I.S., Suponeva N.A., Piradov M.A., 20222022Пойдашева А.Г., Синицын Д.О., Бакулин И.С., Супонева Н.А., Пирадов М.А.Poydasheva A.G., Sinitsyn D.O., Bakulin I.S., Suponeva N.A., Piradov M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1855

The use of high-frequency repetitive transcranial magnetic stimulation (rTMS) in patients with a drug-resistant depressive episode is associated with a high variability of its effect, which determines the relevance of the search for predictive biomarkers of the effect.

Objective

Objective: to search for neuroimaging biomarkers of the clinical effectiveness of navigational rTMS in patients with a drug-resistant depressive episode.

Patients and methods

Patients and methods. The study included 30 patients with a drug resistant depressive episode who underwent 20 sessions of navigational highfrequency rTMS of the dorsolateral prefrontal cortex (DLPFC) of the left hemisphere. We performed an analysis of correlations between functional connectivity and gray matter volume (GMV) in given areas (before rTMS) with the degree of reduction in the Beck score for assessment of depression and the presence of a clinically significant response to therapy.

Results and discussion

Results and discussion. A relationship was shown between the clinical effect and low values of functional connectivity between the subgenual cingulated cortex and DLPFC of the right hemisphere. A relationship was found between a decrease in the severity of symptoms of depression and the volume of GMV in the insula, inferior frontal gyrus, temporal pole, superior temporal gyrus, and median cingulate cortex of the left hemisphere, as well as a relationship between the presence of a significant response to therapy and the volume of GMV in the insula, inferior frontal gyrus, temporal pole and superior temporal gyrus on the left.

Conclusion

Conclusion. The obtained results may become a prerequisite for the development of individual predictive biomarkers of the effectiveness of rTMS in patients with a resistant depressive episode.

Применение высокочастотной ритмической транскраниальной магнитной стимуляции (рТМС) у пациентов с фармакорезистентным депрессивным эпизодом ассоциировано с высокой вариабельностью эффекта, что определяет актуальность поиска предиктивных биомаркеров эффекта.Цель исследования – поиск нейровизуализационных биомаркеров клинической эффективности навигационной рТМС у пациентов с фармакорезистентным депрессивным эпизодом.Пациенты и методы. В исследование было включено 30 пациентов с фармакорезистентным депрессивным эпизодом, которым проводилось 20 сессий навигационной высокочастотной рТМС дорсолатеральной префронтальной коры (ДЛПФК) левого полушария. Проводился анализ корреляций функциональной коннективности и объема серого вещества головного мозга (СВГМ) в заданных зонах (до рТМС) со степенью редукции балла по шкале Бэка для оценки депрессии и наличием клинически значимого ответа на терапию.Результаты и обсуждение. Показана связь между клиническим эффектом и низкими значениями функциональной коннективности между субгенуальной поясной корой и ДЛПФК правого полушария. Выявлена связь между снижением выраженности симптомов депрессии и объемом СВГМ в области островка, нижней лобной извилины, височного полюса, верхней височной извилины и срединной поясной коры левого полушария, а также связь между наличием значимого ответа на терапию и объемом СВГМ в области островка, нижней лобной извилины, височного полюса и верхней височной извилины слева.Заключение. Полученные результаты могут стать предпосылкой к разработке индивидуальных предиктивных биомаркеров эффективности рТМС у пациентов с резистентным депрессивным эпизодом.

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The authors declare that there are no conflicts of interest present.