Motor cortical plasticity as a predictor of treatment response to high frequency repetitive transcranial magnetic stimulation (rTMS) for cognitive function in drug-naive patients with major depressive disorder

Xingxing Li; Chang Yu; Yan Ding; Zan Chen; Wenhao Zhuang; Zhiwang Liu; Jialin Fan; Hui Yan; Weiqian Xu; Guidong Zhu; Xiangyang Zhang; Dongsheng Zhou

doi:10.1016/j.jad.2023.04.085

Motor cortical plasticity as a predictor of treatment response to high frequency repetitive transcranial magnetic stimulation (rTMS) for cognitive function in drug-naive patients with major depressive disorder

J Affect Disord. 2023 Aug 1:334:180-186. doi: 10.1016/j.jad.2023.04.085. Epub 2023 May 4.

Authors

Xingxing Li¹, Chang Yu¹, Yan Ding¹, Zan Chen¹, Wenhao Zhuang¹, Zhiwang Liu¹, Jialin Fan², Hui Yan³, Weiqian Xu⁴, Guidong Zhu⁵, Xiangyang Zhang⁶, Dongsheng Zhou⁷

Affiliations

¹ Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
² The Second People's Hospital of Lishui, Lishui, Zhejiang, China.
³ Taizhou Second People's Hospital, Taizhou, Zhejiang, China.
⁴ Taizhou Second People's Hospital, Taizhou, Zhejiang, China. Electronic address: zjttxwq@163.com.
⁵ The Second People's Hospital of Lishui, Lishui, Zhejiang, China. Electronic address: hzzcer@126.com.
⁶ CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China. Electronic address: zhangxy@psych.ac.cn.
⁷ Ningbo Kangning Hospital, Ningbo, Zhejiang, China. Electronic address: wyzhouds@sina.com.

PMID: 37149052
DOI: 10.1016/j.jad.2023.04.085

Abstract

Background: There is growing evidence that repetitive transcranial magnetic stimulation (rTMS) can improve cognitive function in patients with major depressive disorder (MDD). Few biomarkers are currently available to predict cognitive response in MDD patients. This study aimed to examine whether cortical plasticity played an important role in improving cognitive deficits in MDD patients treated with rTMS.

Methods: A total of 66 MDD patients and 53 healthy controls were recruited. MDD patients were randomly assigned to receive 10 Hz active or sham rTMS 5 days per week for 4 weeks. Cognitive function was assessed using the Repeatable Battery for assessing Neuropsychological Status (RBANS), while depressive symptoms were assessed with the Hamilton Rating Scale for Depression (HRSD-24) before and after treatment. We combined transcranial magnetic stimulation and muscle surface electrophysiological recording to measure plasticity in motor cortex areas in healthy controls at baseline and MDD patients before and after treatment.

Results: Compared with healthy controls, cortical plasticity was impaired in MDD patients. Moreover, cortical plasticity was correlated with RBANS total score at baseline in MDD patients. After 4-week 10 Hz rTMS treatment, the impaired cortical plasticity was restored to some extent. Interestingly, 10 Hz rTMS treatment produced effective therapeutic effects on immediate memory, attention, and RBANS total score. Pearson correlation analysis shows that improvements in plasticity were positively correlated with improvement of immediate memory and RBANS total score.

Conclusions: Our results show for the first time that 10 Hz rTMS can effectively treat impaired cortical plasticity and cognitive impairment in MDD patients and that changes in plasticity and cognitive function are closely related, which may indicate that motor cortical plasticity may play a vital role in cognitive impairment and that cortical plasticity may serve as a potential predictive biomarker for cognitive improvement in MDD patients.

Keywords: Cognitive; Cortical plasticity; Depression; rTMS.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cognition
Depressive Disorder, Major* / drug therapy
Depressive Disorder, Treatment-Resistant* / drug therapy
Humans
Motor Cortex*
Prefrontal Cortex
Transcranial Magnetic Stimulation / methods
Treatment Outcome