Davis, Simon WBeynel, LysianneNeacsiu, Andrada DLuber, Bruce MBernhardt, ElisabethLisanby, Sarah HStrauman, Timothy J2023-10-032023-10-032023-101697-26002174-0852https://hdl.handle.net/10161/29084<h4>Background</h4>Despite the growing use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression, there is a limited understanding of the mechanisms of action and how potential treatment-related brain changes help to characterize treatment response. To address this gap in understanding we investigated the effects of an approach combining rTMS with simultaneous psychotherapy on global functional connectivity.<h4>Method</h4>We compared task-related functional connectomes based on an idiographic goal priming task tied to emotional regulation acquired before and after simultaneous rTMS/psychotherapy treatment for patients with major depressive disorders and compared these changes to normative connectivity patterns from a set of healthy volunteers (HV) performing the same task.<h4>Results</h4>At baseline, compared to HVs, patients demonstrated <i>hyper</i>connectivity of the DMN, cerebellum and limbic system, and <i>hypo</i>connectivity of the fronto-parietal dorsal-attention network and visual cortex. Simultaneous rTMS/psychotherapy helped to normalize these differences, which were reduced after treatment. This finding suggests that the rTMS/therapy treatment regularizes connectivity patterns in both hyperactive and hypoactive brain networks.<h4>Conclusions</h4>These results help to link treatment to a comprehensive model of the neurocircuitry underlying depression and pave the way for future studies using network-guided principles to significantly improve rTMS efficacy for depression.DepressionFunctional connectivitySelf-system therapyrTMSJournal article2023-10-03