Effectiveness of rTMS treatment for geriatric depression focusing on acetylcholine / GABA function

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K16675
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52030:Psychiatry-related
• Research Institution: Wakayama Medical University
• Principal Investigator: Kita Akira 和歌山県立医科大学, 医学部, 助教 (20735914)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 反復経頭蓋磁気刺激療法 / rTMS / うつ病 / 安静時機能的磁気共鳴画像 / rs-fMRI

Outline of Final Research Achievements

Repetitive transcranial magnetic stimulation (rTMS) exerts its excitatory effects on the left dorsolateral prefrontal cortex in patients with depression by analyzing resting-state functional magnetic resonance imaging (rs-fMRI). This stimulation spreads to the thalamus and visual cortex, potentially regulating their abnormal activities remotely in patients with MDD. Furthermore, the remote effects may extend to depression-related brain regions including the amygdala, nucleus accumbens, anterior insula, and subgenual anterior cingulate cortex, suggesting a normalization of their functional abnormalities. This could contribute to understanding the mechanisms of rTMS therapy.

Free Research Field

精神医学

Academic Significance and Societal Importance of the Research Achievements

反復経頭蓋刺激療法（rTMS）は、非侵襲的に神経可塑性を調節する方法であり、治療抵抗性のうつ病患者への治療法として推奨されるが、本邦での反応率・寛解率は、未だ30-50%にとどまり、その治療機序も明らかでない。本研究の学術的意義・社会的意義は、うつ病患者におけるrTMS治療の機序の解明になりうる、うつ病関連脳領域間の機能異常の正常化の仮説を示したことである。