Repetitive transcranial magnetic stimulation and regional cerebral glucose metabolism in major depression patients

Abstract

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Objectives: The aims of this prospective study were to assess the abnormal brain glucose metabolism in major depression patients and to evaluate possible changes of glucose metabolism after intermittent theta burst repetitive transcranial magnetic stimulation(iTBS).

Methods: Seven major depression patients (5 female & 2 male, aged:31.7±6.6 yr) were included by DSM IV criteria. Hamilton’s depression scales (HAM-D) was used for the psychometric assay. The therapy was applied to patient’s left prefrontal area with 15 min iTBS for 10 days. Each iTBS consists 10 bursts of three 50Hz pulses at 5 Hz given every 10 seconds for 20 times. FDG-PET was arranged 7 days before and 3rd day after iTBS. Statistical analysis was performed using SPM5 statistical software implemented in Matlab (version 7.4).

Results: The glucose metabolism was decreased in bilateral inferior frontal and anterior cingulated gyri in depressed patients as compared to healthy controls. Five patients had symptomatic improvement according to HAM-D after iTBS. However, FDG PET showed no significant glucose metabolism change after iTBS.

Conclusions: The lower brain glucose metabolism in bilateral inferior frontal and anterior cingulated gyri might be associated with the pathophysiology of major depression. In spite of symptomatic improvement in 71% (5/7) of depressed patients, no significant regional glucose metabolic change was observed at the 3rd day after iTBS. We will continue to collect more patients for further study.

Research Support: National Science Council of Taiwan (NSC-96-2321-B-182A-006)