Journal: Brain Stimulation (2018)
Authors: Cohen R, Pell G, Roth Y, Tendler A, Zangen A
Background:
TMS-EEG is a rapidly growing area that can be used to assess cortical activity in response to TMS pulses with high temporal resolution.
Objective:
To evaluate EEG features following single dTMS pulses as a potential biomarker for treatment outcome in MDD patients.
Methods:
27 healthy controls and 32 MDD subjects underwent 50 single pulses during EEG recording. These recordings were repeated once a week during 4 weeks of treatment. Data was cleaned and the following features were extracted: Peak amplitude and temporal frequency spectrum in the theta, alpha and beta bands. Noisy recordings based on high Z-scores were excluded. Resting state MRI was also carried out.
Results:
The amplitude of the P200 in a central ICA component between the first session and last recording (post 4-week treatment) correlates to the clinical change in the HDRS-21 score with an R2 = 0.43 (p<0.001). The P200-N100 slope in the first session predicts the treatment outcome with an R2=0.32 (p<0.01). Resting state MRI analysis highlighted an area located at the ACC.
Conclusions:
TMS-EEG shows great potential to develop into a practical tool to obtain biomarkers for predicting treatment outcomes, thereby reducing unnecessary treatments and costs. The increasing number of TMS-EEG recordings by groups around the world together with the development of novel analysis strategies, marks this space as a growth-area with an exciting future. The goal is to develop an array of robust biomarkers to predict and inform the treatment of brain diseases with non-invasive neuro-stimulation.
