The Acute Cerebral Reaction And Imaging Mechanism Research Of TMS On Esophageal Cancer Patients With Depression

Objective: Using functional magnetic resonance imaging(fMRI)to investigate the alteration of spontaneous neural activation,functional connectivity of esophageal cancer patients with depression after repetitive transcranial magnetic stimulation(rTMS)treatment;to discuss the treatment effects and rehabilitation mechanism.Methods: The esophageal cancer patients with major depression(MD)were collected from the Cancer Center of our hospital between August 2015 and December 2015.All of the 11 recruited patients received one session rTMS treatment.Before and immediately after the rTMS stimulation,the resting state fMRI(rs-f MRI)examination and clinical assessment were performed for each patient.The comparison of amplitude of low frequency fluctuation(ALFF)of rs-fMRI between pre and post rTMS treatment groups was calculated and the different brain regions related with depression were selected as regions of interest(ROIs).Moreover,the correlations between the ALFF value alteration in the ROIs and the differences of Hamilton Depression Scale(HAMD)before and after rTMS treatment.Besides,the alteration of functional connectivity between these ROIs pre and post rTMS treatment was also estimated.Results: Compared with the clinical assessment scores before rTMS treatment,the HAMD significantly decreased after r TMS(t =-7.63,p = 0.000).The right superior frontal cortex,bilateral middle frontal cortices,right inferior orbitofrontal gyrus,bilateral anterior cingulate cortices,right hippocampus,bilateral middle temporal gyri,and left inferior temporal gyrus revealed significantly increased ALFF.But,in the bilateral putamen,left thalamus,left posterior cingulate gyrus,and the right middle temporal cortex,the ALFF is significantly decreased(p = 0.02).The alteration of ALFF in the anterior cingulate gyrus was negative correlated with the alteration of HAMD(r =-0.76,p = 0.0065).In addition,the limbic-cortical-striatal-thalamic network also increased in MD patients after r TMS treatment.Conclusion: rTMS may improve the spontaneous neural activity of MD patients,modulate the limbic-cortical-striatal-thalamic network,and achieve the effect of rehabilitation.