Title
Effects of bilateral sequential theta-burst stimulation on 5-HT1A receptors in the dorsolateral prefrontal cortex in treatment-resistant depression: a proof-of-concept trial
Author
Matej Murgaš
Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry, Medical University of Vienna
Author
Jakob Unterholzner
Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry, Medical University of Vienna
Author
Peter Stöhrmann
Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry, Medical University of Vienna
... show all
Abstract
Theta-burst stimulation (TBS) represents a brain stimulation technique effective for treatment-resistant depression (TRD) as underlined by meta-analyses. While the methodology undergoes constant refinement, bilateral stimulation of the dorsolateral prefrontal cortex (DLPFC) appears promising to restore left DLPFC hypoactivity and right hyperactivity found in depression. The post-synaptic inhibitory serotonin-1A (5-HT1A) receptor, also occurring in the DLPFC, might be involved in this mechanism of action. To test this hypothesis, we performed PET-imaging using the tracer [carbonyl-11C]WAY-100635 including arterial blood sampling before and after a three-week treatment with TBS in 11 TRD patients compared to sham stimulation (n = 8 and n = 3, respectively). Treatment groups were randomly assigned, and TBS protocol consisted of excitatory intermittent TBS to the left and inhibitory continuous TBS to the right DLPFC. A linear mixed model including group, hemisphere, time, and Hamilton Rating Scale for Depression (HAMD) score revealed a 3-way interaction effect of group, time, and HAMD on specific distribution volume (VS) of 5-HT1A receptor. While post-hoc comparisons showed no significant changes of 5-HT1A receptor VS in either group, higher 5-HT1A receptor VS after treatment correlated with greater difference in HAMD (r = −0.62). The results of this proof-of-concept trial hint towards potential effects of TBS on the distribution of the 5-HT1A receptor. Due to the small sample size, all results must, however, be regarded with caution.
Keywords
DepressionNeuroscience
Object type
Language
English [eng]
Persistent identifier
https://phaidra.univie.ac.at/o:2046410
Appeared in
Title
Translational Psychiatry
Volume
13
ISSN
2158-3188
Issued
2023
Publisher
Springer Science and Business Media LLC
Date issued
2023
Access rights
Rights statement
© The Author(s) 2023
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