Macroscopic resting state model predicts theta burst stimulation response: A randomized trial

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Kaboodvand, NedaKarolinska Institutet,Uppsala universitet,Psykiatri,Stanford Univ, Dept Neurol & Neurol Sci, Stanford, CA 94305 USA.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden. (author)

Macroscopic resting state model predicts theta burst stimulation response : A randomized trial

Article/chapterEnglish2023

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2023-03-06
Public Library of Science (PLoS),2023
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LIBRIS-ID:oai:DiVA.org:uu-499930
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-499930URI
https://doi.org/10.1371/journal.pcbi.1010958DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:152167190URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Repetitive transcranial magnetic stimulation (rTMS) is a promising alternative therapy for treatment-resistant depression, although its limited remission rate indicates room for improvement. As depression is a phenomenological construction, the biological heterogeneity within this syndrome needs to be considered to improve the existing therapies. Whole-brain modeling provides an integrative multi-modal framework for capturing disease heterogeneity in a holistic manner.Computational modelling combined with a probabilistic nonparametric fitting was applied to the resting-state fMRI data from 42 patients (21 women), to parametrize baseline brain dynamics in depression. All patients were randomly assigned to two treatment groups, namely active (i.e., rTMS, n = 22) or sham (n = 20). The active treatment group received rTMS treatment with an accelerated intermittent theta burst protocol over the dorsomedial prefrontal cortex. The sham treatment group underwent the identical procedure but with the magnetically shielded side of the coil.We stratified the depression sample into distinct covert subtypes based on their baseline attractor dynamics captured by different model parameters. Notably, the two detected depression subtypes exhibited different phenotypic behaviors at baseline. Our stratification could predict the diverse response to the active treatment that could not be explained by the sham treatment. Critically, we further found that one group exhibited more distinct improvement in certain affective and negative symptoms. The subgroup of patients with higher responsiveness to treatment exhibited blunted frequency dynamics for intrinsic activity at baseline, as indexed by lower global metastability and synchrony.Our findings suggested that whole-brain modeling of intrinsic dynamics may constitute a determinant for stratifying patients into treatment groups and bringing us closer towards precision medicine.

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Iravani, BehzadKarolinska Institutet,Stanford Univ, Dept Neurol & Neurol Sci, Stanford, CA 94305 USA.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden. (author)
van den Heuvel, MartijnVrije Univ Amsterdam, Ctr Neurogenom & Cognit Res, Dept Complex Traits Genet, Amsterdam, Netherlands. (author)
Persson, Jonas,1983-Uppsala universitet,Psykiatri(Swepub:uu)jonpe389 (author)
Bodén, Robert,1973-Uppsala universitet,Psykiatri(Swepub:uu)robod677 (author)
Uppsala universitetPsykiatri (creator_code:org_t)

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In:PloS Computational Biology: Public Library of Science (PLoS)19:31553-734X1553-7358

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Psychiatry

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Neurosciences

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