The effect of repetitive transcranial magnetic stimulation on dorsolateral prefrontal glutamate in youth with treatment-resistant depression
Notice bibliographique
Résumé
Major Depressive Disorder (MDD) is a debilitating psychiatric disorder characterized by feelings of low self-worth, loss of interest and suicidal thoughts. An estimated 350 million people are affected worldwide, 15% being adolescents. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive intervention that modulates cortical excitability by inducing electric currents in neurons by administering pulsating magnetic fields to the scalp. Studies have shown the left dorsolateral prefrontal cortex (DLPFC) to be implicated in positive effects on emotion, and glutamate/Glx levels to be decreased in MDD patients. In adults, rTMS has been shown to significantly improve mood, decrease Hamilton Depression Scores and increase glutamate, glutamine and choline levels in the DLPFC. We hypothesize an increase in DLPFC glutamate levels following treatment. Eleven treatment-resistant MDD patients (4 females and 7 males, ages 15-21) were recruited and clinically assessed using the Hamilton Depression/Anxiety Rating Scale and the Children’s Depression Rating Scale at baseline, and during each week of treatment for three weeks. Participants also underwent baseline and post-treatment MRI scans. Magnetic resonance spectroscopy was used to measure glutamate levels and data was analysed using the LC model method. TMS treatments were performed daily for three weeks and treatment response was defined as ≥50% decrease in baseline Ham-D rating scale. In general, rTMS treatments were well tolerated, however some patients described minor side effects of mild headaches and scalp discomfort. Seven patients were treatment responders who showed symptom improvement, a 62% decrease in Ham-D scores from 25.43 (±7.85) to 9.57 (±1.51) and a 30% decrease in CDRS scores from 74.43 (±11.04) to 52.14 (±8.99). Ham-A scores decreased 78% from 23.86 (±9.65) to 5.29 (±3.55). In the left DLPFC, treatment responder glutamine levels increased by 5% and Glx levels increased by 10% in the DLPFC. Responders also showed lower baseline glutamate levels at 8.73 (±1.21) mmol/kg-wet-weight, which increased by 12% to 9.77 (±1.18) following treatment. Interestingly, non-responders had higher baseline glutamate levels at 11.87 (±0.47) and levels decreased by 9% to 10.75 (±0.13). These findings are consistent with previous literature. Evidence of increases in excitatory neurotransmitter levels in the DLPFC and alleviation of symptoms following treatment indicate that rTMS exerts anti-depressant effects and can be pursued as a safe and effective therapy for adolescent MDD.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».