On the Concurrent Use of Self-System Therapy and Functional Magnetic Resonance Imaging-Guided Transcranial Magnetic Stimulation as Treatment for Depression.
| dc.contributor.author | Neacsiu, Andrada D | |
| dc.contributor.author | Luber, Bruce M | |
| dc.contributor.author | Davis, Simon W | |
| dc.contributor.author | Bernhardt, Elisabeth | |
| dc.contributor.author | Strauman, Timothy J | |
| dc.contributor.author | Lisanby, Sarah H | |
| dc.date.accessioned | 2024-06-14T15:12:16Z | |
| dc.date.available | 2024-06-14T15:12:16Z | |
| dc.date.issued | 2018-12 | |
| dc.description.abstract | ObjectivesDespite the growing use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for unipolar depression, its typical effect sizes have been modest, and methodological and conceptual challenges remain regarding how to optimize its efficacy. Linking rTMS to a model of the neurocircuitry underlying depression and applying such a model to personalize the site of stimulation may improve the efficacy of rTMS. Recent developments in the psychology and neurobiology of self-regulation offer a conceptual framework for identifying mechanisms of action in rTMS for depression, as well as for developing guidelines for individualized rTMS treatment. We applied this framework to develop a multimodal treatment for depression by pairing self-system therapy (SST) with simultaneously administered rTMS delivered to an individually targeted region of dorsolateral prefrontal cortex identified via functional magnetic resonance imaging (fMRI).MethodsIn this proof-of-concept study, we examined the acceptability, feasibility, and preliminary efficacy of combining individually fMRI-targeted rTMS with SST. Using the format of a cognitive paired associative stimulation paradigm, the treatment was administered to 5 adults with unipolar depression in an open-label trial.ResultsThe rTMS/SST combination was well tolerated, feasible, and acceptable. Preliminary evidence of efficacy also was promising. We hypothesized that both treatment modalities were targeting the same neural circuitry through cognitive paired associative stimulation, and observed changes in task-based fMRI were consistent with our model. These neural changes were directly related to improvements in depression severity.ConclusionsThe new combination treatment represents a promising exemplar for theory-based, individually targeted, multimodal intervention in mood disorders. | |
| dc.identifier.issn | 1095-0680 | |
| dc.identifier.issn | 1533-4112 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Ovid Technologies (Wolters Kluwer Health) | |
| dc.relation.ispartof | The journal of ECT | |
| dc.relation.isversionof | 10.1097/yct.0000000000000545 | |
| dc.rights.uri | ||
| dc.subject | Prefrontal Cortex | |
| dc.subject | Humans | |
| dc.subject | Magnetic Resonance Imaging | |
| dc.subject | Treatment Outcome | |
| dc.subject | Combined Modality Therapy | |
| dc.subject | Feasibility Studies | |
| dc.subject | Self Concept | |
| dc.subject | Depressive Disorder, Major | |
| dc.subject | Psychiatric Status Rating Scales | |
| dc.subject | Middle Aged | |
| dc.subject | Female | |
| dc.subject | Male | |
| dc.subject | Transcranial Magnetic Stimulation | |
| dc.subject | Self Report | |
| dc.subject | Cognitive Behavioral Therapy | |
| dc.title | On the Concurrent Use of Self-System Therapy and Functional Magnetic Resonance Imaging-Guided Transcranial Magnetic Stimulation as Treatment for Depression. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Neacsiu, Andrada D|0000-0002-9779-7276 | |
| duke.contributor.orcid | Davis, Simon W|0000-0002-5943-0756 | |
| duke.contributor.orcid | Strauman, Timothy J|0000-0002-0310-4505 | |
| duke.contributor.orcid | Lisanby, Sarah H|0000-0003-2037-6470 | |
| pubs.begin-page | 266 | |
| pubs.end-page | 273 | |
| pubs.issue | 4 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | Sanford School of Public Policy | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Trinity College of Arts & Sciences | |
| pubs.organisational-group | Faculty | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Pathology | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences | |
| pubs.organisational-group | Psychology & Neuroscience | |
| pubs.organisational-group | University Initiatives & Academic Support Units | |
| pubs.organisational-group | University Institutes and Centers | |
| pubs.organisational-group | Duke Institute for Brain Sciences | |
| pubs.organisational-group | Duke-UNC Brain Imaging and Analysis Center | |
| pubs.organisational-group | Neurology | |
| pubs.organisational-group | Neurology, Behavioral Neurology | |
| pubs.organisational-group | Initiatives | |
| pubs.organisational-group | Duke Science & Society | |
| pubs.organisational-group | Center for Cognitive Neuroscience | |
| pubs.organisational-group | Center for Child and Family Policy | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences, Adult Psychiatry & Psychology | |
| pubs.publication-status | Published | |
| pubs.volume | 34 |
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