Prefrontal rTMS Modulates Emotion Processing Circuitry
Poster No:
109
Submission Type:
Abstract Submission
Authors:
Maria Vasileiadi1, Anna-Lisa Schuler2, Michael Woletz1, Sarah Grosshagauer1, Christian Windischberger1, NOLAN WILLIAMS3, Martin Tik1,3
Institutions:
1Medical University of Vienna, Vienna, Austria, 2Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, 3Stanford University, California, United States
First Author:
Co-Author(s):
Martin Tik
Medical University of Vienna|Stanford University
Vienna, Austria|California, United States
Medical University of Vienna|Stanford University
Vienna, Austria|California, United States
Introduction:
Major depressive disorder (MDD) is characterized by significant changes in brain activity during emotional processing, particularly in the left dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and amygdala (Jaworska et al., 2015; Simon et al., 2022). Transcranial magnetic stimulation (TMS) targeting the left DLPFC has been validated as an effective therapy for treatment-resistant MDD (Chen et al., 2023). The current study aims to explore the impact of left DLPFC-targeted TMS on emotion-processing circuits. We employ an emotion discrimination task (EDT), previously established to engage areas critical for face recognition and emotion processing (Geissberger et al., 2020; Hariri et al., 2002), within a sham-controlled experimental design.
Methods:
10 healthy volunteers (age M = 26.6, SD = 4.8) participated in the current study. The study consisted of two sessions including left DLPFC stimulation and vertex (sham) stimulation. In each session, participants first completed a run of the EDT. In each EDT trial, subjects were presented with three emotional faces, one on top and two on the bottom and were instructed to either match the PERSON or the EMOTION of the top face to one of the bottom faces. In the control condition, the object discrimination task (ODT), patients were instructed to match OBJECTS presented in the same position as the faces in the test condition on backgrounds of similar color distribution.
Images were acquired on a SIEMENS Magnetom 7T whole-body MR scanner, using a 32-channel head coil with the CMRR multiband (Moeller et al., 2010) EPI sequence (TR = 1.4s, TE = 23ms, 78 slices, voxel size = 1.5x1.5x1mm3). After completion of the first EDT run, subjects were transported out of the scanner room on a MR compatible stretcher. Subsequently, stimulation was performed using a MRi-B91 TMS coil and a MagProX100 stimulator (MagVenture, Denmark). In one session, neuronavigated 10 Hz TMS was applied to a predefined left DLPFC target based on the individual functional connectivity (Fox et al., 2012) and in another session the vertex (sham) was targeted. The order of sham and real stimulation was counterbalanced across subjects. An overview of the experimental procedure can be seen in Figure 1.
Images were acquired on a SIEMENS Magnetom 7T whole-body MR scanner, using a 32-channel head coil with the CMRR multiband (Moeller et al., 2010) EPI sequence (TR = 1.4s, TE = 23ms, 78 slices, voxel size = 1.5x1.5x1mm3). After completion of the first EDT run, subjects were transported out of the scanner room on a MR compatible stretcher. Subsequently, stimulation was performed using a MRi-B91 TMS coil and a MagProX100 stimulator (MagVenture, Denmark). In one session, neuronavigated 10 Hz TMS was applied to a predefined left DLPFC target based on the individual functional connectivity (Fox et al., 2012) and in another session the vertex (sham) was targeted. The order of sham and real stimulation was counterbalanced across subjects. An overview of the experimental procedure can be seen in Figure 1.
·Figure 1
Results:
The behavioral results indicated no significant differences in accuracy for all conditions before (M = 0.93 , SD = 0.05) and after stimulation (M = 0.93, SD = 0.03). No differences in response times were observed when comparing averages before (M =1.23s , SD = 0.17) and after stimulation (M = 1.26s, SD = 0.21). The EDT revealed brain activity patterns (Figure 2A) in accordance with those described in literature (Spies et al., 2017). In the contrast of EDT and ODT, a deactivation in the anterior cingulate cortex (ACC) was observed following TMS over the left DLPFC (Figure 2B, t = 4.59, p < 0.001, FWE-corrected cluster-level). Notably, there were no observed differences in brain activity before and after sham stimulation in the comparison between EDT and ODT. Importantly, the observed effect can not be ascribed to a mere task repetition effect as we have previously established the high reliability of task activation over sessions and runs (Geissberger et al., 2020).
·Figure 2
Conclusions:
Here, we find evidence that stimulation over prefrontal areas modulates emotion-processing related activity in a key region of the default mode network (DMN). This aligns with the broader literature that emphasizes the significance of the subgenual anterior cingulate cortex (sgACC), a component of the DMN, in depression (Cash et al., 2019). Previous research has revealed that down-regulation of the DMN correlates with reduced depressive symptoms (Spies et al., 2017). The current observation, in a healthy subject sample, provides mechanistic evidence that more pronounced inhibition of the DMN might be a key factor in mitigating depressive states through TMS.
Brain Stimulation:
TMS 1
Emotion, Motivation and Social Neuroscience:
Emotional Perception 2
Modeling and Analysis Methods:
Activation (eg. BOLD task-fMRI)
Novel Imaging Acquisition Methods:
BOLD fMRI
Keywords:
Affective Disorders
Cognition
Cortex
Emotions
FUNCTIONAL MRI
HIGH FIELD MR
Psychiatric Disorders
Transcranial Magnetic Stimulation (TMS)
Other - Depression
1|2Indicates the priority used for review
Provide references using author date format
Chen, L. (2023). Accelerated Repetitive Transcranial Magnetic Stimulation to Treat Major Depression: The Past, Present, and Future. Harvard Review of Psychiatry, 31(3), 142. https://doi.org/10.1097/HRP.0000000000000364
Fox, M. D. (2005). The human brain is intrinsically organized into dynamic, anticorrelated functional networks. Proceedings of the National Academy of Sciences, 102(27), 9673-9678.
Fox, M. D. (2012). Efficacy of Transcranial Magnetic Stimulation Targets for Depression Is Related to Intrinsic Functional Connectivity with the Subgenual Cingulate. Biological Psychiatry, 72(7), 595–603. https://doi.org/10.1016/j.biopsych.2012.04.028
Geissberger, N. (2020). Reproducibility of amygdala activation in facial emotion processing at 7T. NeuroImage, 211, 116585. https://doi.org/10.1016/j.neuroimage.2020.116585
Jaworska, N. (2015). A review of fMRI studies during visual emotive processing in major depressive disorder. The World Journal of Biological Psychiatry, 16(7), 448–471.
Moeller, S. (2010). Multiband multislice GE-EPI at 7 tesla, with 16-fold acceleration using partial parallel imaging with application to high spatial and temporal whole-brain fMRI. Magnetic Resonance in Medicine, 63(5), 1144–1153. https://doi.org/10.1002/mrm.22361
Simon, M. (2022). MDD patients with early life stress deactivate the frontostriatal network during facial emotion recognition paradigm: A functional MRI study. European Psychiatry, 65(S1), S78–S79.
Spies, M. (2017). Default mode network deactivation during emotion processing predicts early antidepressant response. Translational Psychiatry, 7(1), e1008–e1008.