{"title":"细胞内和细胞外白质微观形态预测经颅磁刺激对重度抑郁症患者的抗抑郁作用","authors":"Sirui Wang, Xiaochen Zhang, Gai Kong, Yuhao Lin, Tianyuan Zhu, Zhenying Qian, Lihua Xu, Huiru Cui, Jijun Wang, Hui Li, Yingying Tang","doi":"10.1155/da/1749444","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Background:</b> Transcranial magnetic stimulation (TMS) is a widely used treatment for major depressive disorders (MDD). However, its physiological effects remain unclear, and its efficacy varies among patients. Functional connectivity (FC) within MDD-related networks has shown potential for predicting TMS efficacy. White matter (WM) micromorphology contributes to these connections and may provide new insights into the prediction of TMS effects and its antidepressant mechanism in MDD, which has not been thoroughly investigated. Therefore, this study aimed to identify potential predictors of TMS efficacy using whole-brain WM microstructural characteristics.</p>\n <p><b>Methods:</b> This retrospective study included 41 patients with MDD who completed 20-session TMS treatments. We examined intra- and extracellular WM using neurite orientation dispersion and density imaging (NODDI). We examined the correlations between pre-TMS whole-brain WM measures and the reduction in Montgomery–Åsberg Depression Rating Scale (MADRS) scores after TMS, as well as the longitudinal changes in regional WM measures correlated with MADRS reduction.</p>\n <p><b>Results:</b> The pre-TMS intracellular neurite density index (NDI) within the bilateral internal capsule (IC), right posterior corona radiata (PCR), right superior corona radiata (SCR), corpus callosum (CC), and bilateral posterior thalamic radiation (PTR) were positively associated with the reduction in MADRS scores. The pre-TMS extracellular free-water fraction (FWF) within the bilateral IC, splenium of the CC, and right SCR was significantly related to the reduction in MADRS scores. The FWF within the left posterior limb of the IC, left PCR, and left SCR decreased after TMS treatment.</p>\n <p><b>Limitations:</b> The study’s findings cannot rule out the potential effects of concurrent pharmaceutical therapies, as a control group not receiving TMS treatment was not included.</p>\n <p><b>Conclusions:</b> Regional NDI and FWF values at baseline could predict TMS efficacy in patients with MDD. Reducing the extracellular FWF in the left hemisphere may be a potential therapeutic mechanism of TMS in MDD.</p>\n </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/1749444","citationCount":"0","resultStr":"{\"title\":\"Intra- and Extracellular White Matter Micromorphology Predict the Antidepressant Effects of Transcranial Magnetic Stimulation in Patients With Major Depressive Disorder\",\"authors\":\"Sirui Wang, Xiaochen Zhang, Gai Kong, Yuhao Lin, Tianyuan Zhu, Zhenying Qian, Lihua Xu, Huiru Cui, Jijun Wang, Hui Li, Yingying Tang\",\"doi\":\"10.1155/da/1749444\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Background:</b> Transcranial magnetic stimulation (TMS) is a widely used treatment for major depressive disorders (MDD). However, its physiological effects remain unclear, and its efficacy varies among patients. Functional connectivity (FC) within MDD-related networks has shown potential for predicting TMS efficacy. White matter (WM) micromorphology contributes to these connections and may provide new insights into the prediction of TMS effects and its antidepressant mechanism in MDD, which has not been thoroughly investigated. Therefore, this study aimed to identify potential predictors of TMS efficacy using whole-brain WM microstructural characteristics.</p>\\n <p><b>Methods:</b> This retrospective study included 41 patients with MDD who completed 20-session TMS treatments. We examined intra- and extracellular WM using neurite orientation dispersion and density imaging (NODDI). We examined the correlations between pre-TMS whole-brain WM measures and the reduction in Montgomery–Åsberg Depression Rating Scale (MADRS) scores after TMS, as well as the longitudinal changes in regional WM measures correlated with MADRS reduction.</p>\\n <p><b>Results:</b> The pre-TMS intracellular neurite density index (NDI) within the bilateral internal capsule (IC), right posterior corona radiata (PCR), right superior corona radiata (SCR), corpus callosum (CC), and bilateral posterior thalamic radiation (PTR) were positively associated with the reduction in MADRS scores. The pre-TMS extracellular free-water fraction (FWF) within the bilateral IC, splenium of the CC, and right SCR was significantly related to the reduction in MADRS scores. The FWF within the left posterior limb of the IC, left PCR, and left SCR decreased after TMS treatment.</p>\\n <p><b>Limitations:</b> The study’s findings cannot rule out the potential effects of concurrent pharmaceutical therapies, as a control group not receiving TMS treatment was not included.</p>\\n <p><b>Conclusions:</b> Regional NDI and FWF values at baseline could predict TMS efficacy in patients with MDD. Reducing the extracellular FWF in the left hemisphere may be a potential therapeutic mechanism of TMS in MDD.</p>\\n </div>\",\"PeriodicalId\":55179,\"journal\":{\"name\":\"Depression and Anxiety\",\"volume\":\"2025 1\",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-02-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/1749444\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Depression and Anxiety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/da/1749444\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Depression and Anxiety","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/da/1749444","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Intra- and Extracellular White Matter Micromorphology Predict the Antidepressant Effects of Transcranial Magnetic Stimulation in Patients With Major Depressive Disorder
Background: Transcranial magnetic stimulation (TMS) is a widely used treatment for major depressive disorders (MDD). However, its physiological effects remain unclear, and its efficacy varies among patients. Functional connectivity (FC) within MDD-related networks has shown potential for predicting TMS efficacy. White matter (WM) micromorphology contributes to these connections and may provide new insights into the prediction of TMS effects and its antidepressant mechanism in MDD, which has not been thoroughly investigated. Therefore, this study aimed to identify potential predictors of TMS efficacy using whole-brain WM microstructural characteristics.
Methods: This retrospective study included 41 patients with MDD who completed 20-session TMS treatments. We examined intra- and extracellular WM using neurite orientation dispersion and density imaging (NODDI). We examined the correlations between pre-TMS whole-brain WM measures and the reduction in Montgomery–Åsberg Depression Rating Scale (MADRS) scores after TMS, as well as the longitudinal changes in regional WM measures correlated with MADRS reduction.
Results: The pre-TMS intracellular neurite density index (NDI) within the bilateral internal capsule (IC), right posterior corona radiata (PCR), right superior corona radiata (SCR), corpus callosum (CC), and bilateral posterior thalamic radiation (PTR) were positively associated with the reduction in MADRS scores. The pre-TMS extracellular free-water fraction (FWF) within the bilateral IC, splenium of the CC, and right SCR was significantly related to the reduction in MADRS scores. The FWF within the left posterior limb of the IC, left PCR, and left SCR decreased after TMS treatment.
Limitations: The study’s findings cannot rule out the potential effects of concurrent pharmaceutical therapies, as a control group not receiving TMS treatment was not included.
Conclusions: Regional NDI and FWF values at baseline could predict TMS efficacy in patients with MDD. Reducing the extracellular FWF in the left hemisphere may be a potential therapeutic mechanism of TMS in MDD.
期刊介绍：
Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.
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