Critical role of rhythms in prefrontal transcranial magnetic stimulation for depression: A randomized sham-controlled study.

Repetitive transcranial magnetic stimulation (rTMS) is an alternative treatment for depression, but the neural correlates of the treatment are currently inconclusive, which might be a limit of conventional analytical methods. The present study aimed to investigate the neurophysiological evidence and potential biomarkers for rTMS and intermittent theta burst stimulation (iTBS) treatment. A total of 61 treatment-resistant depression patients were randomly assigned to receive prolonged iTBS (piTBS; N = 19), 10 Hz rTMS (N = 20), or sham stimulation (N = 22). Each participant went through a treatment phase with resting state electroencephalography (EEG) recordings before and after the treatment phase. The aftereffects of stimulation showed that theta-alpha amplitude modulation frequency (fam ) was associated with piTBS_Responder, which involves repetitive bursts delivered in the theta frequency range, whereas alpha carrier frequency (fc ) was related to 10 Hz rTMS, which uses alpha rhythmic stimulation. In addition, theta-alpha amplitude modulation frequency was positively correlated with piTBS antidepressant efficacy, whereas the alpha frequency was not associated with the 10 Hz rTMS clinical outcome. The present study showed that TMS stimulation effects might be lasting, with changes of brain oscillations associated with the delivered frequency. Additionally, theta-alpha amplitude modulation frequency may be as a function of the degree of recovery in TRD with piTBS treatment and also a potential EEG-based predictor of antidepressant efficacy of piTBS in the early treatment stage, that is, first 2 weeks.

Event-related components are structurally represented by intrinsic event-related potentials.

The detection of event-related potentials (ERPs) through electroencephalogram (EEG) analysis is a well-established method for understanding brain functions during a cognitive process. To increase the signal-to-noise ratio (SNR) and stationarity of the data, ERPs are often filtered to a wideband frequency range, such as 0.05-30 Hz. Alternatively, a natural-filtering procedure can be performed through empirical mode decomposition (EMD), which yields intrinsic mode functions (IMFs) for each trial of the EEG data, followed by averaging over trials to generate the event-related modes. However, although the EMD-based filtering procedure has advantages such as a high SNR, suitable waveform shape, and high statistical power, one fundamental drawback of the procedure is that it requires the selection of an IMF (or a partial sum of a range of IMFs) to determine an ERP component effectively. Therefore, in this study, we propose an intrinsic ERP (iERP) method to overcome the drawbacks and retain the advantages of event-related mode analysis for investigating ERP components. The iERP method can reveal multiple ERP components at their characteristic time scales and suitably cluster statistical effects among modes by using a tailored definition of each mode's neighbors. We validated the iERP method by using realistic EEG data sets acquired from a face perception task and visual working memory task. By using these two data sets, we demonstrated how to apply the iERP method to a cognitive task and incorporate existing cluster-based tests into iERP analysis. Moreover, iERP analysis revealed the statistical effects between (or among) experimental conditions more effectively than the conventional ERP method did.