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TITLE
Rostral Anterior Cingulate Cortex is a Structural Correlate of rTMS Treatment Response in Depression

SOURCE
Brain Stimulation. 11(3):575-581, 2018 May – Jun.

AUTHORS
Boes AD; Uitermarkt BD; Albazron FM; Lan MJ; Liston C; Pascual-Leone A; Dubin MJ; Fox MD.

BACKGROUND
Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for medication-refractory major depression, yet the mechanisms of action for this intervention are poorly understood. Here we investigate cerebral cortex thickness as a possible biomarker of rTMS treatment response.

METHODS
Longitudinal change in cortical thickness is evaluated relative to clinical outcomes across 48 participants in 2 cohorts undergoing left dorsolateral prefrontal cortex rTMS as a treatment for depression.

RESULTS
Our results reveal changes in thickness in a region of the left rostral anterior cingulate cortex that correlate with clinical response, with this region becoming thicker in patients who respond favorably to rTMS and thinner in patients with a less favorable response. Moreover, the baseline cortical thickness in this region correlates with rTMS treatment response – those patients with thinner cortex before treatment tended to have the most clinical improvement.

CONCLUSIONS
This study is the first analysis of longitudinal cortical thickness change with rTMS as a treatment for depression with similar results across two cohorts. These results support further investigation into the use of structural MRI as a possible biomarker of rTMS treatment response.

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