Potentiation of quantitative electroencephalograms following prefrontal repetitive transcranial magnetic stimulation in patients with major depression

Neurosci Res. 2013 Sep-Oct;77(1-2):70-7. doi: 10.1016/j.neures.2013.06.002. Epub 2013 Jul 1.


The long-lasting effects of repetitive transcranial magnetic stimulation (rTMS) on electroencephalogram (EEG) activity are not clear. We aimed to investigate the cumulative rTMS effects on EEG and clinical outcomes in patients with major depression. Twenty-five patients with medication-resistant depression underwent 10 daily rTMS sessions over the left dorsolateral prefrontal cortex. We measured resting EEG and spectrum-power before and after the rTMS course. Clinical efficacy was evaluated with the Hamilton's Depression Rating Scale (HAM-D) and Wisconsin Card Sorting Test (WCST). In an ANOVA model, including all prefrontal electrodes, post hoc analyses revealed significant time effects on the theta (F1,24 = 7.89, P = 0.010; +43%), delta (F1,24 = 6.58, P = 0.017; +26%), and alpha (F1,24 = 4.64, P = 0.042; 31%) bands without site specificity. Clinical correlations were observed between F4 alpha power increases and improvements in HAM-D retardation, F3 alpha power increases and improvements of the absolute changes in perseveration and error number on the WCST, and C3 and C4 theta power increases and improvements of the percent change in perseveration and error number on the WCST following rTMS. Consecutive prefrontal rTMS could induce long-lasting EEG potentiations beyond the aftereffects, resulting in improved cognitive and depressive symptoms.

Keywords: ACC; ANOVA; DLPFC; DMN; Depression; Dorsolateral prefrontal cortex (DLPFC); E-LTP; ED; EEG; EMG; FDI; FFT; Fm-theta; HAM-D; HFS; Hamilton's Rating Scale for Depression; ICD-10; L-LTP; LORETA; LTP; M1; MEP; MRI; MSO; Neuromodulation; Quantitative electroencephalogram (qEEG); RMT; Repetitive transcranial stimulation (rTMS); SCID-I; SD; Structured Clinical Interview for DSM-IV Axis I Disorders; WCST; Wisconsin Card Sorting Test; analysis of variance; anterior cingulate cortex; default mode network; dorsolateral prefrontal cortex; early phase long term potentiation; electroencephalography; electromyography; equivalent dose; fast Fourier transform; first dorsal interosseous; front midline theta; high frequency stimulation; international classification of disease 10th; late phase-long term potentiation; long term potentiation; low resolution brain electromagnetic tomography; magnetic resonance imaging; maximum stimulator output; motor evoked potential; primary motor cortex; qEEG; quantitative electroencephalography; rTMS; repetitive transcranial magnetic stimulation; resting motor threshold; standard deviation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Waves / physiology*
  • Depressive Disorder, Major / physiopathology*
  • Electroencephalography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prefrontal Cortex / physiopathology*
  • Time Factors
  • Transcranial Magnetic Stimulation*