EEG microstates reveal brain network dynamics changes with circuit-targeted TMS on anhedonia.
Poster No:
598
Submission Type:
Abstract Submission
Authors:
QiangYan Che1, Xinyu Huang1, Xingyu Zhao1, Ya Fang1, Rong Ye1, Fengqiong Yu1
Institutions:
1Anhui Medical University, Hefei, Anhui
First Author:
Co-Author(s):
Introduction:
A growing body of neuroimaging studies have implicated anhedonia as a core symptom of major depressive disorder that results from dysfunction in the brain's reward circuitry. These studies have inspired the use of transcranial magnetic stimulation (TMS) targeted to sites connected to the reward circuit as a treatment for anhedonia. Yet its mechanism of action is still not known. High temporal resolution of Electroencephalography (EEG) "microstates" as a tool for studying the temporal dynamics of whole-brain neuronal networks. Therefore, the aim of this study is to investigate the therapeutic impact of circuit-targeted TMS on network dynamics in depressive patients along with anhedonia as well as to explore relationship between microstates and therapeutic efficacy.
Methods:
49 patients of major depressive disorder （MDD） along with anhedonia symptoms age =22.5±7.7）, were enrolled for this randomized, sham-controlled, double-blind trial. We also recruited 15 age - and sex-matched healthy controls. patients were randomly assigned to either Active TMS group（26 subjects） or Sham group （23 subjects）. Each participant received once-daily session of TMS treatment for 15 days with10 Hz frequency and 100% motor threshold, using either active or sham coil. Stimulation was localized to the site of strongest left dorsolateral prefrontal cortex （DLPFC）–nucleus accumbens （NAcc） network by functional magnetic resonance imaging. The Hamilton depression rating scale （HAMD） was used to measure depression severity, the temporal experience pleasure scale （TEPS） to measure anhedonia symptoms. Polarity-insensitive modified k-means clustering was used to segment EEG microstates into four canonical microstates (A-D). Independent samples t-tests were used to compare the microstate characteristics between patients and healthy controls. Linear mixed effects models tested for within-subject differences over time and microstate features between Active group and Sham group. To understand the relationship between TMS clinic efficacy and microstate characteristics. Linear mixed effects models were used to test for differences in microstate metrics over time between responder and non-responder groups.
Results:
Compared with healthy controls, patients show a decreased metrics of microstate C(Occurrence P=0.0002,PFDR=0.002,Cohen's d=1.12;Contribution P=0.004, PFDR =0.025, Cohen's d=0.84)and increased metrics of microstate D(Duration P= 0.006,PFDR=0.025,Cohen's d=0.81;Contribution P=0.015, PFDR =0.046, Cohen's d=0.71) . Linear mixed effects models reveal significant interaction effect of group × time on the microstate C (Occurrence F= 5.053,p =0.029; Contribution F =5.006, p =0.030) reflecting increases over time in microstate C on Active group. Clinical response to TMS was associated with increases in features of microstate C(Occurrence F=6.075,p= 0.012; Duration F=4.875,p= 0.037)and decreases in features of microstate D(Occurrence F=5.158,p= 0.032; Contribution F=7.418,p= 0.012; Duration F=4.4079,p= 0.046) . Non-responders showed no significant changes in any microstate. Linear mixed effects models also show significant interaction effect of group × time on the TEPS total score(F =6.724, p =0.013) reflecting increases over time in TEPS total score on Active TMS group, as well as the main effect of time(F =11.692, p =0.001).
Conclusions:
Reduction of metrics microstate C in depressive patients with anhedonia symptoms can be selective modulated through intervention with TMS targeting the left DLPFC–NAcc network. Our finding suggests that microstate C may be closely related to the reward network and anhedonia severity. Furthermore, we identify the changes of microstate C and D are associated with effectiveness of outcome for circuit-based TMS with anhedonia symptoms. Overall, resting-state EEG microstates seems a promising tool for monitoring illness severity and evaluating treatment efficacy through objective neurophysiological biomarkers in psychiatric disorders.
Brain Stimulation:
TMS
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Emotion, Motivation and Social Neuroscience:
Emotion and Motivation Other
Modeling and Analysis Methods:
EEG/MEG Modeling and Analysis 2
Keywords:
Electroencephaolography (EEG)
Transcranial Magnetic Stimulation (TMS)
Other - Microstates , Major Depressive Disorder, Anhedonia, Neuromodulation
1|2Indicates the priority used for review
·Study Workflow ,Microstate Topographies , Representation and Microstate Changes in Patients of Major Depressive Disorder(MDD) along with Anhedonia and Healthy Controls
·Categorical Microstate Changes After TMS Course and Clinical Symptoms Improvement
Provide references using author date format
Gold, M. C. (2022), "Large-scale EEG neural network changes in response to therapeutic TMS," Brain Stimulation, vol. 15, no. 2, pp. 316-325.
Michel, C. M. (2018), "EEG microstates as a tool for studying the temporal dynamics of whole-brain neuronal networks: A review," Neuroimage, vol. 180, pp. 577-593.
Murphy, M. (2020), "Abnormalities in electroencephalographic microstates are state and trait markers of major depressive disorder," Neuropsychopharmacology, vol. 45, no. 12, pp. 2030-2037.
Poulsen 2018），"Microstate EEGlab toolbox: an introductory guide”, bioRxiv:289850.
Treadway, M. T. (2011), "Reconsidering anhedonia in depression: Lessons from translational neuroscience," Neuroscience and Biobehavioral Reviews, vol. 35, no. 3, pp. 537-555.
Williams L. M. (2017), "Defining biotypes for depression and anxiety based on large-scale circuit dysfunction: a theoretical review of the evidence and future directions for clinical translation," Depression and anxiety, vol. 34, no. 1, pp. 9-24.
Wang, X. (2021), "Therapeutic efficacy of connectivity-directed transcranial magnetic stimulation on anticipatory anhedonia," (in eng), Depression and anxiety, vol. 38, no. 9, pp. 972-984.