Improved Pre-attentive Processing With Occipital rTMS Treatment in Major Depressive Disorder Patients Revealed by MMN

Muzhen Guan; Xufeng Liu; Li Guo; Ruiguo Zhang; Qingrong Tan; Huaihai Wang; Huaning Wang

doi:10.3389/fnhum.2021.648816

Improved Pre-attentive Processing With Occipital rTMS Treatment in Major Depressive Disorder Patients Revealed by MMN

Front Hum Neurosci. 2021 Jun 8:15:648816. doi: 10.3389/fnhum.2021.648816. eCollection 2021.

Authors

Muzhen Guan^{1

2}, Xufeng Liu³, Li Guo¹, Ruiguo Zhang⁴, Qingrong Tan¹, Huaihai Wang⁵, Huaning Wang¹

Affiliations

¹ Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China.
² Department of Mental Health, Xi'an Medical University, Xi'an, China.
³ School of Military Medical Psychology, Air Force Medical University, Xi'an, China.
⁴ Department of Psychiatry, Xi'an No. 3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, China.
⁵ Department of Psychiatry, Xi'an Union Hospital, Xi'an, China.

Abstract

Objectives: To investigate the improvement effect of occipital repetitive transcranial magnetic stimulation (rTMS) combined with escitalopram oxalate tablets on pre-attentive processing in patients with first-episode, medication-naive depression.

Methods: Patients who were hospitalized between January and December 2019 were selected. They were randomly allocated to real occipital rTMS stimulation group with 27 cases receiving intermittent theta-burst (iTBS) and sham stimulation group with 24 cases over 20 days. The rTMS treatment target is located at the Oz point of the occipital region. Both groups took escitalopram oxalate tablets, and the average daily drug dose was 15.294 ± 5.041 mg. Hamilton Depression Rating Scale (HAMD) was used to assess the symptoms of depression before and after treatment, and mismatch negativity (MMN) was used to assess the improvement of pre-attentive processing before and after treatment.

Results: After 20 days of treatment, the total score of HAMD (13.495 ± 3.700) in both groups was significantly lower than that before treatment [21.910 ± 3.841, F(1, 49) = 46, 3.690, p < 0.001]. After treatment, the latency of MMN in the real stimulation group (182.204 ± 31.878 ms) was significantly lower than that in the sham stimulation group (219.896 ± 42.634 ms, p < 0.001), and the amplitude of MMN in the real stimulation group (-7.107 ± 3.374 ms) was significantly higher than that in the sham stimulation group (-2.773 ± 3.7 32 ms, p < 0.001).

Conclusion: Occipital rTMS treatment can enhance the early therapeutic effect and effectively improve the pre-attentive processing of patients with depression and provide a scientific basis for the new target of rTMS therapy in clinical patients with depression.

Keywords: event-related potentials; major depressive disorder; mismatch negativity; occipital lobe; repetitive transcranial magnetic stimulation.