Investigating neural nircuit engagement in depression with interleaved TMS-fMRI

In this presentation, I will discuss the use of interleaved intermittent theta-burst stimulation (iTBS) and functional MRI to investigate real-time neural circuit engagement in patients with depression. This approach addresses the challenge of individual variability in response to TMS by allowing direct observation of neural activity at the time of stimulation. By capturing these temporal dynamics, interleaved TMS-fMRI provides unique insights into the neurobiological mechanisms underlying TMS effects. It reveals how stimulation influences the DLPFC-sgACC target network, a critical circuit implicated in depression. Through data from our clinical study, I will demonstrate how this method not only identifies acute brain activity following stimulation but also distinguishes how these patterns differ between responders and non-responders, highlighting individual differences in circuit engagement. By identifying these differences, we’re taking crucial steps toward tailoring treatments to each individual.