Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depression

Background The heterogeneity of depression limits the treatment outcomes of intermittent theta burst stimulation (iTBS) and hinders the identification of predictive factors. This study investigated functional network connectivity and predictors of iTBS treatment outcomes in adolescents and young adu...

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Main Authors: Xiaoyu Chen, Min Zhang, Fan Zhang, Yanling Zhou, Yuping Ning, Roger S McIntyre, Hanna Lu, Haiyan Liu, Yiying Chen, Xiaofeng Lan, Chengyu Wang, Weicheng Li, Zhibo Hu, Siming Mai, Yanan Yin, Zerui You, Guanxi Liu, Zhanjie Luo, Yexian Zeng, Yifang Chen, Robin Shao
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:General Psychiatry
Online Access:https://gpsych.bmj.com/content/38/2/e101749.full
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author Xiaoyu Chen
Min Zhang
Fan Zhang
Yanling Zhou
Yuping Ning
Roger S McIntyre
Hanna Lu
Haiyan Liu
Yiying Chen
Xiaofeng Lan
Chengyu Wang
Weicheng Li
Zhibo Hu
Siming Mai
Yanan Yin
Zerui You
Guanxi Liu
Zhanjie Luo
Yexian Zeng
Yifang Chen
Robin Shao
author_facet Xiaoyu Chen
Min Zhang
Fan Zhang
Yanling Zhou
Yuping Ning
Roger S McIntyre
Hanna Lu
Haiyan Liu
Yiying Chen
Xiaofeng Lan
Chengyu Wang
Weicheng Li
Zhibo Hu
Siming Mai
Yanan Yin
Zerui You
Guanxi Liu
Zhanjie Luo
Yexian Zeng
Yifang Chen
Robin Shao
author_sort Xiaoyu Chen
collection DOAJ
description Background The heterogeneity of depression limits the treatment outcomes of intermittent theta burst stimulation (iTBS) and hinders the identification of predictive factors. This study investigated functional network connectivity and predictors of iTBS treatment outcomes in adolescents and young adults with depression.Aim This study aimed to identify default mode network (DMN)-based connectivity patterns associated with varying iTBS treatment outcomes in depression.Methods Data from a randomised controlled trial of iTBS in depression (n=82) were analysed using a data-driven approach to classify homogeneous subgroups based on the DMN. Connectivity subgroups were compared on depressive symptoms and cognitive function at pretreatment and post-treatment. Furthermore, the predictive significance of baseline inflammatory cytokines on post-treatment outcomes was evaluated.Results Two distinct subgroups were identified. Subgroup 1 exhibited high heterogeneity and greater centrality in the posterior cingulate cortex and retrosplenial cortex, while subgroup 2 showed more homogeneous connectivity patterns and greater centrality in the temporoparietal junction and posterior inferior parietal lobule. No main effect for subgroup, treatment or subgroup×treatment interaction was revealed in the improvement of depressive symptoms. A significant subgroup×treatment interaction related to symbol coding improvement was detected (F=5.22, p=0.026). Within subgroup 1, the active group showed significantly greater improvement in symbol coding compared with the sham group (t=2.30, p=0.028), while baseline levels of interleukin-6 and C-reactive protein emerged as significant indicators for predicting improvements in symbolic coding (R2=0.35, RMSE (root-mean-square error)=5.72, p=0.013). Subgroup 2 showed no significant findings in terms of cognitive improvement or inflammatory cytokines predictions.Conclusions Data-driven network analyses offer valuable insights into iTBS treatment outcomes in depression, providing clues for predicting cognitive improvements from an inflammatory perspective.Trial registration number ChiCTR2100042346.
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spelling doaj-art-72f5774cabaa454ca823d6d8e16c70e72025-08-20T02:57:08ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2025-04-0138210.1136/gpsych-2024-101749Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depressionXiaoyu Chen0Min Zhang1Fan Zhang2Yanling Zhou3Yuping Ning4Roger S McIntyre5Hanna Lu6Haiyan Liu7Yiying Chen8Xiaofeng Lan9Chengyu Wang10Weicheng Li11Zhibo Hu12Siming Mai13Yanan Yin14Zerui You15Guanxi Liu16Zhanjie Luo17Yexian Zeng18Yifang Chen19Robin Shao20Department of Physiology, Anhui Medical University, Hefei, Anhui, ChinaGuangzhou University of Traditional Chinese Medicine Maoming Hospital, Maoming, Guangdong, China1 Department of Critical Care Medicine, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaThe Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, ChinaAffiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China6 Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada1Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Pathogenic Microbiology and Immunology, Xi’an Jiaotong University, Xi’an, ChinaInstitute of Chronic Non-communicable Diseases, Center for Disease Control and Prevention of Jiangxi Province, Nanchang, Jiangxi, ChinaAffiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, ChinaAffiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, ChinaAffiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, ChinaAffiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, ChinaAffiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China1 Department of Child and Adolescent Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China1 Department of Child and Adolescent Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China1 Department of Child and Adolescent Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China1 Department of Child and Adolescent Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China1 Department of Child and Adolescent Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China1 Department of Child and Adolescent Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China5 State Key Laboratory of Brain and Cognitive Sciences, Department of Psychology, The University of Hong Kong, Hong Kong, ChinaBackground The heterogeneity of depression limits the treatment outcomes of intermittent theta burst stimulation (iTBS) and hinders the identification of predictive factors. This study investigated functional network connectivity and predictors of iTBS treatment outcomes in adolescents and young adults with depression.Aim This study aimed to identify default mode network (DMN)-based connectivity patterns associated with varying iTBS treatment outcomes in depression.Methods Data from a randomised controlled trial of iTBS in depression (n=82) were analysed using a data-driven approach to classify homogeneous subgroups based on the DMN. Connectivity subgroups were compared on depressive symptoms and cognitive function at pretreatment and post-treatment. Furthermore, the predictive significance of baseline inflammatory cytokines on post-treatment outcomes was evaluated.Results Two distinct subgroups were identified. Subgroup 1 exhibited high heterogeneity and greater centrality in the posterior cingulate cortex and retrosplenial cortex, while subgroup 2 showed more homogeneous connectivity patterns and greater centrality in the temporoparietal junction and posterior inferior parietal lobule. No main effect for subgroup, treatment or subgroup×treatment interaction was revealed in the improvement of depressive symptoms. A significant subgroup×treatment interaction related to symbol coding improvement was detected (F=5.22, p=0.026). Within subgroup 1, the active group showed significantly greater improvement in symbol coding compared with the sham group (t=2.30, p=0.028), while baseline levels of interleukin-6 and C-reactive protein emerged as significant indicators for predicting improvements in symbolic coding (R2=0.35, RMSE (root-mean-square error)=5.72, p=0.013). Subgroup 2 showed no significant findings in terms of cognitive improvement or inflammatory cytokines predictions.Conclusions Data-driven network analyses offer valuable insights into iTBS treatment outcomes in depression, providing clues for predicting cognitive improvements from an inflammatory perspective.Trial registration number ChiCTR2100042346.https://gpsych.bmj.com/content/38/2/e101749.full
spellingShingle Xiaoyu Chen
Min Zhang
Fan Zhang
Yanling Zhou
Yuping Ning
Roger S McIntyre
Hanna Lu
Haiyan Liu
Yiying Chen
Xiaofeng Lan
Chengyu Wang
Weicheng Li
Zhibo Hu
Siming Mai
Yanan Yin
Zerui You
Guanxi Liu
Zhanjie Luo
Yexian Zeng
Yifang Chen
Robin Shao
Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depression
General Psychiatry
title Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depression
title_full Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depression
title_fullStr Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depression
title_full_unstemmed Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depression
title_short Neural connectivity biotypes: predictors of clinical outcomes and improvement patterns of iTBS treatment in adolescents and young adults with depression
title_sort neural connectivity biotypes predictors of clinical outcomes and improvement patterns of itbs treatment in adolescents and young adults with depression
url https://gpsych.bmj.com/content/38/2/e101749.full
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