Status message

Not the entire site translated, but only to "Journal"

The spectral characteristics of the electroencephalogram (EEG) is the potential biomarkers of efficacy of Transcranial Magnetic Stimulation (TMS) in resistant depression

T.S. Melnikova , E.E. Tsukarzi , A.V. Kovalev , S.N. Mosolov
Federal Medical Research Centre of Psychiatry and Narcology of Ministry of health of the Russian Federation


Objectives. The purpose of the study was to find possible biomarkers of TMS effectiveness in resistant depression patients through comparative analysis of the spectral characteristics of EEG in responders (R) and nonresponders (NR) on TMS.

Methods. The study included 32 patients with treatment-resistant depression with the severity of symptoms, according to the Hamilton scale (17 items) of at least 20 points (mean 24.73.6 points). TMS was performed on a magnetic stimulator “Neuro-MS” on the left dorsolateral prefrontal cortex, 12 sessions of 15 Hz, 100 % of the threshold intensity. To the end of TMS course 20 patients (> 50 % reduction of HAM-D total score) were assigned to the group of R, and the rest (n = 12) consisted of a group of NR.

Results. Differences between EEG of R and NR revealed when comparing the value of the asymptotic-symmetry of alpha activity. Pronounced differences in the structure of the main rhythm in R and NR in comparative analysis of background EEG in the quantization to 1 Hz was found in the right occipital region. Theta activity of R not only had a lower representation in all areas of the cortex, but also did not show a significant breach of hemispheric balance both in the frontal areas of the cortex, and in the temporal areas. At NR more pronounced reduction of the alpha rhythm mainly in the amplification of slow-wave activity of delta and theta spectrum, as well as the high activity of the beta range. Discriminant analysis of obtained data show that differences in EEG patterns R and NR no longer differ in the analysis of individual indicators of EEG rhythms, and in their combinations, in particular ratios of the alpha rhythm and theta bands. Moreover, the greatest weight is related to the ratio of spectral power (SP) of alpha and theta rhythms in leads T3 and T5. The higher this ratio, the higher the probability of a hit in the responder group of patients and, therefore, predict favorable effect of TMS. Positive values (Y > 0) of discriminant scores are efficiency biomarker of TMS treatment in resistant depression.

Conclusion. Obtained formula (classification function) allows to predict the effect of TMS with specially-computed index of patient's EEG. At the same time these data need to be clarified in future researches.


It appears your Web browser is not configured to display PDF files. Download adobe Acrobat or click here to download the PDF file.

  • 1. Varlamov A.A., Strelets V. B. Analiz kogerentnosti EEG pri depressivnykh rasstroistvakh: sovremennoe sostoyanie i perspektivy klinicheskogo primeneniya // Vysshaya nervnaya deya-tel'nost'. – 2013. – T. 63, № 6. – S. 613–624.
  • 2. Mel'nikova T.S., Tsukarzi E.E., Kovalev A.V., Mosolov S.N. Dinamika spektral'nykh kharak-teristik EEG pri primenenii transkranial'noi magnitnoi stimulyatsii (TMS) u bol'nykh rezistentnymi depressiyami // Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. – 2015. – № 8. – S. 59–65.
  • 3. Mel'nikova T.S., Mosolov S.N., Tsukarzi E.E., Mitrofanov A.A., Kovalev A.V. EEG-prediktory effektivnosti lecheniya depressivnykh rasstroistv // Sb. mat. Vseros. nauchno-prakt. konf. s mezhdunar. uchastiem «Psikhiatriya na etapakh reform: problemy i perspekti-vy». 23–26 sentyabrya 2015 g., g. Kazan' / Pod obshch. red. N.G. Neznanova. – SPb.: Al'ta Astra, 2015. – S. 457–459.
  • 4. Mosolov S.N., Alfimov P.V., Kostyukova E.G. Sovremennye metody preodoleniya terapevti-cheskoi rezistentnosti pri rekurrentnoi depressii // Biologicheskie metody terapii psi-khicheskikh rasstroistv. Dokazatel'naya meditsina – klinicheskoi praktike / Pod red. S.N. Mosolova. – M., 2012. – S. 438–473.
  • 5. Tsukarzi E.E., Il'in S.A., Mosolov S.N. Primenenie transkranial'noi magnitnoi stimu-lyatsii i elektrosudorozhnoi terapii pri terapevticheski rezistentnykh depressiyakh // Sovre-mennaya terapiya psikhicheskikh rasstroistv. – 2015. – № 4. – S. 25–33.
  • 6. Tsukarzi E.E. Sovremennye metody stimulyatsii mozga: dostizheniya i perspektivy primene-niya // Zhurnal sotsial'noi i klinicheskoi psikhiatrii. – 2013. – T. 23, № 1. – S. 93–99.
  • 7. Davidson R.J. Affective Style and Affective Disorders: Perspectives from Affective Neuroscience // Cognition & Emotion. – 1998. – Vol. 12 (3). – P. 307–330.
  • 8. Debener S., Beauducel A., Nessler D., Brocke B., Heilemann H., Kayser J. Is resting anterior EEG alpha asymmetry a trait marker for depression? Findings for healthy adults and clinically depressed patients // Neuropsychobiology. – 2000. – Vol. 41. – P. 31–37.
  • 9. Dunlop B.W., Mayberg H.S. Neuroimaging-based biomarkers for treatment selection in major de-pressive disorder // Dialogues Clin Neurosci. – 2014. – Vol. 16 (4). – P. 479–490.
  • 10. Chen B., Dowlatshahi D., MacQeen G.M. et al. Increased hippocampal BDNF immunoreactivity in subjects treatment with antidepressant medication // Biol. Psychiatry. – 2001. – Vol. 50. – P. 260–265.
  • 11. Farzan F., Barr M., Fitzgerald P. Transcranial magnetic stimulation on the modulation of gamma oscillations in schizophrenia // Annual N Y Acad Sci. – 2012. – Vol. 1265. – P. 25–35.
  • 12. Fu C.H., Steiner H., Costafreda S.G. Predictive neural biomarkers of clinical response in depres-sion: a meta-analysis of functional and structural neuroimaging studies of pharmacological and psy-chological therapies // Neurobiol Dis. – 2013. – Vol. 52. – P. 75–83. − doi: 10.1016/j.nbd.2012.05.008.
  • 13. Jin Y., Phillips B. A pilot study of the use of EEG-based synchronized Transcranial Magnetic Stim-ulation (sTMS) for treatment of Major Depression // BMC Psychiatry. – 2014. – Vol. 14. – P. 13. Published online Jan 18, 2014. − doi: 10.1186/1471-244X-14-13.
  • 14. George M.S., Taylor J.J., Short E.B. The Expanding Evidence Base for rTMS Treatment of Depres-sion // Curr Opin Psychiatry. – 2013. – Vol. 26 (1). – P. 13–18. doi: 10.1097/YCO.0b013e32835ab46d
  • 15. Hasan A., Strube W., Palm U., Wobrock T. Repetitive Noninvasive Brain Stimulation to Modulate Cognitive Functions in Schizophrenia: A Systematic Review of Primary and Secondary Outcomes // Schizophrenia Bulletin. – 2016. – Vol. 42, suppl. 1. – P. S95–S109. − doi: 10.1093/schbul/sbv158.
  • 16. Higgins E.S., George M.S. Brain Stimulation Therapies for Clinicians. – Washington: American Psychiatric Press, 2008.
  • 17. Kellner S.N. Brain stimulation in psychiatry: ECT, DBS, TMS and other modalities. – NY: Cam-bridge University Press, 2012.
  • 18. Marshall P.J., Fox NA: Emotion regulation, depression, and hemispheric asymmetry, in Stress, Coping, and Depression / Edited by Johnson S.L., Hayes A.M. − Mahwah, NJ: Lawrence Erlbaum Associates, 2000. – P. 35–50.
  • 19. Martinot P.M.L., Galinowski A., Ringuenet D., Olié J.P. Influence of prefrontal target region on the efficacy of repetitive transcranial magnetic stimulation in patients with medication-resistant depres-sion: a [(18)F]-fluorodeoxyglucose PET and MRI study // Int J Neuropsychopharmacol. – 2010, Feb. – Vol. 13 (1). – P. 45–59.
  • 20. Tomarken A.J. Keener-Miller A.D. Frontal brain asymmetry and depression: a self-regulatory per-spective // Cognition Emotion. – 1998. – Vol. 12. – P. 387–420.
  • 21. Speer A.M., Kimbrell T.A., Wassermann E.M., Repella J. et al. Opposite effects of high and low frequency rTMS on regional brain activity in depressed patients // Biological Psychiatry. – 2000. – Vol. 48 (12). – P. 1133–1141.