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The neurobiological impact of high frequency repetitive transcranial magnetic stimulation on the underlying neurocircuitry of depressed mood

Scriptie/Masterproef: Doctoral Thesis

Samenvatting

Repetitive Transcranial Magnetic Stimulation
(rTMS) is safely used to treat psychiatric
illnesses, especially major depression. By using
TMS ‘off-line’ paradigms, the main purpose of this
thesis was to evaluate the neurobiological effects
of fixed high frequency (HF)-rTMS parameters on
mood changes in healthy subjects, as well as in
unipolar TRD patients of the melancholic subtype.
The absence of HF-rTMS effects on the HPA-axis
in non-depressed subjects, in contrast to the
effects found in depressed individuals could imply
that the neurobiological influences of HF-rTMS
are specific for a given pathophysiological
condition. The ‘hypersensitive’ HPA-axis, only
observed in HF-rTMS non-responders, indicates
that only those depressed patients with some
kind of ‘normal or preserved’ cortico-subcortical
neurocircuitries could be susceptible to this kind
of treatment. In line with these assumptions, TRD
patients displaying metabolically more active
fronto-cingulate networks responded better to
multiple HF-rTMS sessions. Furthermore, our
results indicate that HF-rTMS treatment affects
(pre)frontal cortical and hippocampal 5-HT2A
receptor binding indices in a different way,
depending as to where these receptors are
located in the brain. In short, our results
demonstrate that HF-rTMS has immediate and
prolonged neurobiological effects on the selected
pathophysiological systems we examined in
melancholic TRD patients. Furthermore, our
results support the choice of the left DLPFC as a
valid HF-rTMS target site to intervene with the
neuronal pathways deregulated in major
depression.
Datum prijs11 jun. 2009
Originele taalEnglish
Prijsuitreikende instantie
  • Vrije Universiteit Brussel
BegeleiderAxel Bossuyt (Promotor), Rudi De Raedt (Promotor), Patrick Haentjens (Jury), Jacques De Keyser (Jury), Ilse Smolders (Jury), Udo Dannlowski (Jury), Kurt Audenaert (Jury) & Stephan Claes (Jury)

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