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Cited by 10Transcranial Magnetic Stimulation StudiesTreatment of Major DepressionElectroconvulsive Therapy Studies

Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Function in Patients With Stress-Related Depression: A Randomized Double-Blind fMRI and 1H-MRS Study

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Chen, Yuxin, Li, Xiuzhen, Wang, Lubin, Tian, Shushi, Chen, Yuanwang, Wang, Feng, Gu, Kesheng, Wang, Ying +13 more·2022·Frontiers in Neurology
DOI 10.3389/fneur.2022.844606PMC PMC9051398
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Abstract

Objectives: To reveal the effects of repetitive transcranial magnetic stimulation (rTMS) on the improvement of cognitive function in patients with stress-related depression, and to enrich the neural mechanism(s) underlying rTMS so as to improve cognitive function in patients with stress-related depression. Methods: We conducted a randomized, double-blind, placebo-controlled study of rTMS in patients with stress-related depression who were 18–40 years of age. Patients were randomly allocated to either a sham or experimental group in a 1:1 ratio. A 10-session rTMS protocol was used with 10-Hz stimulation over the left dorsolateral prefrontal cortex (DLPFC). Clinical assessments (HAMD, HAMA, DASS, MoCA), neuropsychologic (Stroop, WCST), and resting state fMRI and 1 H-MRS assessments were executed at two time points—baseline and after the 10th rTMS session. Results: rTMS relieved the mental symptoms of patients in both groups. The MoCA score of patients in the experimental group increased; the number of correct answers increased significantly in Stroop testing, and the number of errors and omissions decreased significantly; the number of persistent errors decreased significantly; and the time used to complete the test decreased to an even greater extent in the WCST experimental group. The ReHo value in the lingual gyrus of the right hemisphere and the cuneus of the left and right hemispheres in the experimental group decreased after treatment. The DC value in the left and right hemispheric cuneus and postcentral gyrus of the left hemisphere in the experimental group diminished after treatment. The functional connections of these brain regions also changed as the Cho and NAA/Cr of the left DLPFC changed, with alterations related to the improvement in cognitive function. The level of choline (Cho) in the left DLPFC of the experimental group was significantly lower than that of the control group, and the level of N-acetylaspartate/creatine (NAA/Cr) in the left DLPFC of the control group was significantly higher than that of the experimental group. These changes were related to the overall improvement in cognitive function. Conclusions: Ten-Hz rTMS over the left DLPFC improved the cognitive function of patients with stress-related depression. The governing mechanism for this phenomenon may be via rTMS effects on multiple visual-related brain regions and their functional connections, and on the somatosensory cortex and its functional connection with visual and auditory cortex, reducing the level of Cho and stabilizing the level of NAA/Cr in the left DLPFC.

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Authors
Chen, Y., Li, X., Wang, L., Tian, S., Chen, Y., Wang, F., Gu, K., Wang, Y., Xu, G., Zhang, S., Liu, J., Wang, H., Jia, Z., Li, L., Wang, X., Xie, F., Wang, X., Wang, S., Xue, C., Zhao, Y., & Qian, L.
Affiliations
Institute of Basic Medical Sciences of the Chinese Academy of Medical Sciences (CN)
Corresponding author
  • Zhao, Yun
  • Qian, Lingjia
ORCID
Venue
Frontiers in Neurology
Publisher
Frontiers Media SA
Published
2022-04-15
Volume
13
Pages
844606-844606
ISSN
1664-2295 (ISSN-L)
DOI
10.3389/fneur.2022.844606
PMC
PMC9051398
OpenAlex
W4223933230
Cited by
10
References
4
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 2
FWCI
0.79
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Neurology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
repetitive transcranial magnetic stimulation, cognitive function, dorsolateral prefrontal cortex, resting-state functional connectivity, regional homogeneity, choline, visual cortex, somatosensory cortex, neurometabolites, Stroop task, Wisconsin Card Sorting Test, Montreal Cognitive Assessment, therapeutic mechanisms, young adults

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