Impact of transcranial magnetic stimulation therapy on the volumes of amygdala and hippocampal subfields in patients with major depressive disorder

doi:10.3969/j.issn.1674-8115.2025.04.005

Abstract

Abstract:

Objective ·To investigate the longitudinal changes in amygdala and hippocampal subfield volumes before and after transcranial magnetic stimulation (TMS) treatment in patients with major depressive disorder (MDD) and explore their correlation with the antidepressant and anxiolytic efficacy of TMS. Methods ·A total of 58 patients diagnosed with MDD at Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, were included in this study between January 2018 and August 2023. Clinical depressive and anxiety symptoms were assessed by using the Hamilton Depression Scale (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS), and Hamilton Anxiety Scale (HAMA) at baseline and post-TMS treatment. Patients underwent a baseline magnetic resonance imaging (MRI) scan followed by TMS treatment targeting the left dorsolateral prefrontal cortex (DLPFC) at a frequency of 10 Hz, totaling 20 sessions. A follow-up MRI scan was conducted on the same day the TMS treatment concluded. Amygdala and hippocampal subfield volumes were segmented and calculated by using FreeSurfer v6.0.0 software. Longitudinal changes in the subfield volumes were analyzed with two-way analysis of variance. Controlling for age, sex, and intracranial volume, partial correlation analysis was conducted between subfield volumes and baseline clinical scores. The association between the rate of volume change in brain regions with significant volume changes and symptom improvement (reduction in HAMD, MADRS, and HAMA scores) was evaluated. Results ·Following TMS treatment, a significant increase in the volume of the right amygdala central nucleus was observed (t=-2.441, P=0.018). While the volumes of bilateral hippocampal fimbria decreased, the volumes of most hippocampal subfield and the total hippocampus increased (P<0.05). No significant correlations were found between baseline amygdala or hippocampal subfield volumes and clinical depressive and anxiety symptoms. However, only in patients who responded effectively to TMS treatment, a positive correlation was found between the volume change rate of the left hippocampal tail and reductions in anxiety symptoms (HAMA: r=0.334, P=0.044). Conclusion ·High-frequency TMS targeting the left DLPFC may induce volume increases in the right amygdala central nucleus and specific hippocampal subfields. Additionally, the volume change rate of the left hippocampal tail is associated with anti-anxiety effects in TMS responders, suggesting that high-frequency TMS targeting the left DLPFC may induce neuroplastic changes in the central nucleus of the right amygdala and key subfields of the hippocampus.

Key words: major depressive disorder, transcranial magnetic stimulation, amygdala subfield, hippocampal subfield

CLC Number:

R749.4

WANG Sirui, KONG Gai, LI Hui, QIAN Zhenying, CUI Huiru, TANG Yingying. Impact of transcranial magnetic stimulation therapy on the volumes of amygdala and hippocampal subfields in patients with major depressive disorder[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(4): 434-442.

Figures/Tables 7

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References 40

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Clinical scale	Before TMS	After TMS	T value	P value
HAMD-24	27 (12, 40)	10 (0, 27)	3.0	<0.001
MADRS	27 (16, 36)	7 (0, 26)	1.5	<0.001
HAMA	19 (9, 39)	10 (0, 27)	28.0	<0.001

Clinical scale	Before TMS	After TMS	T value	P value
HAMD-24	27 (12, 40)	10 (0, 27)	3.0	<0.001
MADRS	27 (16, 36)	7 (0, 26)	1.5	<0.001
HAMA	19 (9, 39)	10 (0, 27)	28.0	<0.001

Subfield	Time			Laterality			Time × Laterality
Subfield	F value	P value	η²	F value	P value	η²	F value	P value	η²
La	0.897	0.347	0.015	18.151	<0.001	0.242	5.533	0.022	0.088
Ba	0.352	0.556	0.006	59.562	<0.001	0.511	3.425	0.069	0.057
AB	0.075	0.785	0.001	108.26	<0.001	0.655	2.702	0.106	0.045
AAA	3.796	0.056	0.062	89.549	<0.001	0.611	1.767	0.189	0.030
Ce	4.204	0.045	0.069	44.796	<0.001	0.440	2.440	0.124	0.041
Me	2.307	0.134	0.390	29.001	<0.001	0.337	3.143	0.082	0.052
Co	0.242	0.625	0.004	102.340	<0.001	0.642	0.914	0.343	0.016
CAT	0.410	0.525	0.007	59.627	<0.001	0.511	0.281	0.598	0.005
PL	0.446	0.507	0.008	6.263	0.015	0.099	0.030	0.863	0.001
Whole amygdala	0.170	0.681	0.003	83.962	<0.001	0.596	4.825	0.032	0.078

Subfield	Time			Laterality			Time × Laterality
Subfield	F value	P value	η²	F value	P value	η²	F value	P value	η²
La	0.897	0.347	0.015	18.151	<0.001	0.242	5.533	0.022	0.088
Ba	0.352	0.556	0.006	59.562	<0.001	0.511	3.425	0.069	0.057
AB	0.075	0.785	0.001	108.26	<0.001	0.655	2.702	0.106	0.045
AAA	3.796	0.056	0.062	89.549	<0.001	0.611	1.767	0.189	0.030
Ce	4.204	0.045	0.069	44.796	<0.001	0.440	2.440	0.124	0.041
Me	2.307	0.134	0.390	29.001	<0.001	0.337	3.143	0.082	0.052
Co	0.242	0.625	0.004	102.340	<0.001	0.642	0.914	0.343	0.016
CAT	0.410	0.525	0.007	59.627	<0.001	0.511	0.281	0.598	0.005
PL	0.446	0.507	0.008	6.263	0.015	0.099	0.030	0.863	0.001
Whole amygdala	0.170	0.681	0.003	83.962	<0.001	0.596	4.825	0.032	0.078

Subfield	Time			Laterality			Time × Laterality
Subfield	F value	P value	η²	F value	P value	η²	F value	P value	η²
CA1-body	3.910	0.053	0.064	67.705	<0.001	0.543	4.673	0.035	0.067
CA1-head	0.148	0.702	0.003	86.886	<0.001	0.604	1.217	0.275	0.021
CA3-body	12.769	<0.001	0.183	82.281	<0.001	0.591	7.449	0.008	0.166
CA3-head	0.261	0.611	0.005	21.449	<0.001	0.273	1.851	0.179	0.031
CA4-body	6.293	0.015	0.099	1.844	0.180	0.031	0.002	0.968	<0.001
CA4-head	0.026	0.872	0.0005	20.487	<0.001	0.264	3.107	0.083	0.052
Fimbria	15.254	<0.001	0.211	7.824	0.007	0.121	1.837	0.181	0.031
Fissure	0.874	0.354	0.015	1.970	0.166	0.033	0.247	0.621	0.004
GC-DG-body	6.720	0.012	0.105	1.966	0.166	0.033	0.125	0.725	0.002
GC-DG-head	0.001	0.973	<0.001	25.200	<0.001	0.307	2.654	0.109	0.044
HATA	0.370	0.546	0.006	6.398	0.014	0.101	0.684	0.412	0.012
Hippocampus tail	26.765	<0.001	0.320	65.029	<0.001	0.533	0.267	0.608	0.005
ML-body	20.469	<0.001	0.264	44.278	<0.001	0.437	7.873	0.007	0.121
ML-head	0.007	0.936	<0.001	34.724	<0.001	0.379	2.142	0.149	0.036
Parasubiculum	0.064	0.801	0.001	13.377	<0.001	0.190	0.279	0.599	0.005
Presubiculum-body	6.277	0.015	0.099	18.069	<0.001	0.241	1.514	0.224	0.026
Presubiculum-head	3.017	0.083	0.052	15.834	<0.001	0.217	0.637	0.428	0.011
SUB-body	17.011	<0.001	0.230	0.010	0.921	<0.001	1.019	0.317	0.018
SUB-head	0.278	0.600	0.005	1.118	0.295	0.019	0.166	0.685	0.003
Whole hippocampus	10.728	0.002	0.158	65.042	<0.001	0.533	2.941	0.092	0.049
Whole hippocampus-body	14.750	<0.001	0.206	12.169	<0.001	0.176	3.168	0.080	0.053
Whole hippocampus-head	0.034	0.855	0.001	33.231	<0.001	0.368	1.459	0.232	0.025