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Improvement Of Frontal Lobe Dysfunction And White Matter Integrity By rTMS In Treatment-Resistant Depression

Authors Tateishi H, Nishihara M, Kawaguchi A, Matsushima J, Murakawa T, Haraguchi Y, Kunitake Y, Maekawa T, Kato TA, Asami T, Mizoguchi Y, Monji A

Received 23 August 2019

Accepted for publication 22 October 2019

Published 6 November 2019 Volume 2019:15 Pages 3079—3087


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Taro Kishi

Hiroshi Tateishi,1 Masashi Nishihara,2 Atsushi Kawaguchi,3 Jun Matsushima,4 Toru Murakawa,4 Yoshinori Haraguchi,4 Yutaka Kunitake,1 Toshihiko Maekawa,5 Takahiro A Kato,5 Toyoko Asami,6 Yoshito Mizoguchi,4 Akira Monji4

1Department of Psychiatry, Saga University Hospital, Saga 849-8501, Japan; 2Department of Radiology, Saga University Hospital, Saga 849-8501, Japan; 3Center of Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan; 4Department of Psychiatry, Faculty of Medicine, Saga University, Saga 849-8501, Japan; 5Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi Higashi-ku, Fukuoka 842-8582, Japan; 6Department of Rehabilitation Medicine, Saga University Hospital, Saga 849-8501, Japan

Correspondence: Hiroshi Tateishi
Department of Psychiatry, Saga University Hospital, Nabeshima, Saga 849-8501, Japan
Akira Monji
Department of Psychiatry, Faculty of Medicine, Saga University, Nabeshima, Saga 849-8501, Japan

Aim: The impairment experienced by many individuals with depression is closely related to the cognitive symptoms of the disorder. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation method providing a promising technique for improving cognitive symptoms in treatment-resistant depression (TRD). In the present study, we investigated whether a relationship exists between improvements in frontal lobe dysfunction induced by rTMS and improvement of white matter integrity revealed by diffusion tensor imaging (DTI) in TRD patients receiving rTMS treatment.
Methods: A total of 12 patients with TRD were enrolled in a high-frequency (10 Hz) rTMS study (August 2013–January 2019). Frontal lobe function and depressive symptoms were assessed at baseline and at the endpoint of rTMS treatment. Fractional anisotropy (FA), as a measure of white matter integrity obtained from DTI, was investigated using a region-of-interest (ROI) approach.
Results: rTMS treatment significantly improved depressive symptom scores and some subscales of frontal lobe dysfunction. Category scores in the Word Fluency Test and scores on part 3 of the Color Stroop Test were improved independently of the improvement of depressive symptoms. In the ROI analysis, none of the FA increases in any region were correlated with improvement of any frontal lobe function (n = 12).
Conclusion: Although rTMS resulted in partial improvement of frontal lobe dysfunction as well as white matter integrity, we found no correlation between improved frontal lobe dysfunction and improved white matter integrity in TRD patients.

Keywords: repetitive transcranial magnetic stimulation, fractional anisotropy, diffusion tensor imaging, treatment-resistant depression, frontal lobe function

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