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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 9/2011

01-09-2011 | Original Article

Predictive value of brain perfusion SPECT for rTMS response in pharmacoresistant depression

Authors: Raphaelle Richieri, Laurent Boyer, Jean Farisse, Cecile Colavolpe, Olivier Mundler, Christophe Lancon, Eric Guedj

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2011

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Abstract

Purpose

The aim of this study was to determine the predictive value of whole-brain voxel-based regional cerebral blood flow (rCBF) for repetitive transcranial magnetic stimulation (rTMS) response in patients with pharmacoresistant depression.

Methods

Thirty-three right-handed patients who met DSM-IV criteria for major depressive disorder (unipolar or bipolar depression) were included before rTMS. rTMS response was defined as at least 50% reduction in the baseline Beck Depression Inventory scores. The predictive value of 99mTc-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) for rTMS response was studied before treatment by comparing rTMS responders to non-responders at voxel level using Statistical Parametric Mapping (SPM) (p < 0.001, uncorrected).

Results

Of the patients, 18 (54.5%) were responders to rTMS and 15 were non-responders (45.5%). There were no statistically significant differences in demographic and clinical characteristics (p > 0.10). In comparison to responders, non-responders showed significant hypoperfusions (p < 0.001, uncorrected) in the left medial and bilateral superior frontal cortices (BA10), the left uncus/parahippocampal cortex (BA20/BA35) and the right thalamus. The area under the curve for the combination of SPECT clusters to predict rTMS response was 0.89 (p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the combination of clusters were: 94, 73, 81 and 92%, respectively.

Conclusion

This study shows that, in pharmacoresistant depression, pretreatment rCBF of specific brain regions is a strong predictor for response to rTMS in patients with homogeneous demographic/clinical features.
Literature
1.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
2.
World Health Organization. The world health report. Health systems: improving performance. Geneva: World Health Organization; 2000. p. 2000.
3.
Baldwin RC, Simpson S. Treatment resistant depression in the elderly: a review of its conceptualisation, management and relationship to organic brain disease. J Affect Disord 1997;46(3):163–73.PubMedCrossRef
4.
McLoughlin DM, Mogg A, Eranti S, Pluck G, Purvis R, Edwards D, et al. The clinical effectiveness and cost of repetitive transcranial magnetic stimulation versus electroconvulsive therapy in severe depression: a multicentre pragmatic randomised controlled trial and economic analysis. Health Technol Assess 2007;11(24):1–54.PubMed
5.
UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003;361(9360):799–808.CrossRef
6.
Rose D, Fleischmann P, Wykes T, Leese M, Bindman J. Patients’ perspectives on electroconvulsive therapy: systematic review. BMJ 2003;326(7403):1363.PubMedCrossRef
7.
Avery DH, Holtzheimer 3rd PE, Fawaz W, Russo J, Neumaier J, Dunner DL, et al. A controlled study of repetitive transcranial magnetic stimulation in medication-resistant major depression. Biol Psychiatry 2006;59(2):187–94.PubMedCrossRef
8.
Avery DH, Isenberg KE, Sampson SM, Janicak PG, Lisanby SH, Maixner DF, et al. Transcranial magnetic stimulation in the acute treatment of major depressive disorder: clinical response in an open-label extension trial. J Clin Psychiatry 2008;69(3):441–51.PubMedCrossRef
9.
George MS, Lisanby SH, Avery D, McDonald WM, Durkalski V, Pavlicova M, et al. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Arch Gen Psychiatry 2010;67(5):507–16.PubMedCrossRef
10.
Holtzheimer 3rd PE, McDonald WM, Mufti M, Kelley ME, Quinn S, Corso G, et al. Accelerated repetitive transcranial magnetic stimulation for treatment-resistant depression. Depress Anxiety 2010;27(10):960–3.PubMedCrossRef
11.
Grunhaus L, Schreiber S, Dolberg OT, Polak D, Dannon PN. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Biol Psychiatry 2003;53(4):324–31.PubMedCrossRef
12.
Eranti S, Mogg A, Pluck G, Landau S, Purvis R, Brown RG, et al. A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression. Am J Psychiatry 2007;164(1):73–81.PubMedCrossRef
13.
Fregni F, Marcolin MA, Myczkowski M, Amiaz R, Hasey G, Rumi DO, et al. Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation. Int J Neuropsychopharmacol 2006;9(6):641–54.PubMedCrossRef
14.
Kito S, Fujita K, Koga Y. Regional cerebral blood flow changes after low-frequency transcranial magnetic stimulation of the right dorsolateral prefrontal cortex in treatment-resistant depression. Neuropsychobiology 2008;58(1):29–36.PubMedCrossRef
15.
Mottaghy FM, Keller CE, Gangitano M, Ly J, Thall M, Parker JA, et al. Correlation of cerebral blood flow and treatment effects of repetitive transcranial magnetic stimulation in depressed patients. Psychiatry Res 2002;115(1–2):1–14.PubMed
16.
Nadeau SE, McCoy KJ, Crucian GP, Greer RA, Rossi F, Bowers D, et al. Cerebral blood flow changes in depressed patients after treatment with repetitive transcranial magnetic stimulation: evidence of individual variability. Neuropsychiatry Neuropsychol Behav Neurol 2002;15(3):159–75.PubMed
17.
Pizzagalli DA. Frontocingulate dysfunction in depression: toward biomarkers of treatment response. Neuropsychopharmacology 2011;36(1):183–206.PubMedCrossRef
18.
Seminowicz DA, Mayberg HS, McIntosh AR, Goldapple K, Kennedy S, Segal Z, et al. Limbic-frontal circuitry in major depression: a path modeling metanalysis. Neuroimage 2004;22(1):409–18.PubMedCrossRef
19.
Spronk D, Arns M, Barnett KJ, Cooper NJ, Gordon E. An investigation of EEG, genetic and cognitive markers of treatment response to antidepressant medication in patients with major depressive disorder: a pilot study. J Affect Disord 2011;128(1–2):41–8.PubMedCrossRef
20.
Teneback CC, Nahas Z, Speer AM, Molloy M, Stallings LE, Spicer KM, et al. Changes in prefrontal cortex and paralimbic activity in depression following two weeks of daily left prefrontal TMS. J Neuropsychiatry Clin Neurosci 1999;11(4):426–35.PubMed
21.
Declaration of Helsinki. Ethical principles for medical research involving human subjects. World Medical Association, General Assembly, Seoul, October 2008.
22.
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56(6):893–7.PubMedCrossRef
23.
Spielberger CD, Gorsuch RL, Lushene PR, Vagg PR, Jacobs AG. Manual for the state-trait anxiety inventory (form Y). Palo Alto: Consulting Psychologists Press; 1983.
24.
George MS, Wassermann EM, Williams WA, Callahan A, Ketter TA, Basser P, et al. Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. Neuroreport 1995;6(14):1853–6.PubMedCrossRef
25.
Kennedy SH, Evans KR, Krüger S, Mayberg HS, Meyer JH, McCann S, et al. Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression. Am J Psychiatry 2001;158(6):899–905.PubMedCrossRef
26.
Martinot JL, Hardy P, Feline A, Huret JD, Mazoyer B, Attar-Levy D, et al. Left prefrontal glucose hypometabolism in the depressed state: a confirmation. Am J Psychiatry 1990;147(10):1313–7.PubMed
27.
Mayberg HS, Brannan SK, Mahurin RK, Jerabek PA, Brickman JS, Tekell JL, et al. Cingulate function in depression: a potential predictor of treatment response. Neuroreport 1997;8(4):1057–61.PubMedCrossRef
28.
Brunelin J, Poulet E, Boeuve C, Zeroug-vial H, d’Amato T, Saoud M. Efficacy of repetitive transcranial magnetic stimulation (rTMS) in major depression: a review. Encephale 2007;33(2):126–34.PubMedCrossRef
29.
Langguth B, Wiegand R, Kharraz A, Landgrebe M, Marienhagen J, Frick U, et al. Pre-treatment anterior cingulate activity as a predictor of antidepressant response to repetitive transcranial magnetic stimulation (rTMS). Neuro Endocrinol Lett 2007;28(5):633–8.PubMed
30.
Paus T, Barrett J. Transcranial magnetic stimulation (TMS) of the human frontal cortex: implications for repetitive TMS treatment of depression. J Psychiatry Neurosci 2004;29(4):268–79.PubMed
31.
Gershon AA, Dannon PN, Grunhaus L. Transcranial magnetic stimulation in the treatment of depression. Am J Psychiatry 2003;160(5):835–45.PubMedCrossRef
32.
Herwig U, Lampe Y, Juengling FD, Wunderlich A, Walter H, Spitzer M, et al. Add-on rTMS for treatment of depression: a pilot study using stereotaxic coil-navigation according to PET data. J Psychiatr Res 2003;37(4):267–75.PubMedCrossRef
33.
Kimbrell TA, Little JT, Dunn RT, Frye MA, Greenberg BD, Wassermann EM, et al. Frequency dependence of antidepressant response to left prefrontal repetitive transcranial magnetic stimulation (rTMS) as a function of baseline cerebral glucose metabolism. Biol Psychiatry 1999;46(12):1603–13.PubMedCrossRef
34.
Ahdab R, Ayache SS, Brugières P, Goujon C, Lefaucheur JP. Comparison of “standard” and “navigated” procedures of TMS coil positioning over motor, premotor and prefrontal targets in patients with chronic pain and depression. Neurophysiol Clin 2010;40(1):27–36.PubMedCrossRef
35.
Harel EV, Zangen A, Roth Y, Reti I, Braw Y, Levkovitz Y. H-coil repetitive transcranial magnetic stimulation for the treatment of bipolar depression: an add-on, safety and feasibility study. World J Biol Psychiatry 2011;12(2):119–26.PubMedCrossRef
36.
Dreyfus JF, Guelfi JD, Ruschel S, Blanchard C, Pichot P. Factorial analysis of the Hamilton depression scale, II. Ann Med Psychol (Paris) 1981;139(4):446–53.
37.
Guelfi JD, Dreyfus JF, Ruschel S, Blanchard C, Pichot P. Factorial structure of the Hamilton depression scale. I. Ann Med Psychol (Paris) 1981;139(2):199–214.
38.
Peyre F, Martinez R, Calache M, Verdoux H, Bourgeois M. New validation of the Montgomery and Asberg Depression Scale (MADRS) on a sample of 147 hospitalized depressed patients. Ann Med Psychol (Paris) 1989;147(7):762–7.
39.
Chambon O, Poncet F, Kiss L, Milani D, Cottraux J. French adaptation, concurrent validation and factorial analysis of the Bech and Rafaelsen melancholia scale. Encephale 1988;14(6):443–8.PubMed
40.
Bouvard M, Charles S, Guérin J, Aimard G, Cottraux J. Study of Beck’s hopelessness scale. Validation and factor analysis. Encephale 1992;18(3):237–40.PubMed
41.
Collet L, Cottraux J. The shortened Beck depression inventory (13 items). Study of the concurrent validity with the Hamilton scale and Widlöcher’s retardation scale. Encephale 1986;12(2):77–9.PubMed
Metadata
Title
Predictive value of brain perfusion SPECT for rTMS response in pharmacoresistant depression
Authors
Raphaelle Richieri
Laurent Boyer
Jean Farisse
Cecile Colavolpe
Olivier Mundler
Christophe Lancon
Eric Guedj
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2011
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-011-1850-9

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