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Neuroanatomical pathways of TMS therapy for depression

Seguin, C.; Mansour, S.; Betzel, R. F.; Chumin, E.; Puxeddu, M. G.; Lv, J.; Parkes, L.; Cocchi, L.; Fitzgerald, P. B.; Cash, R. F.; Zalesky, A.

2025-02-12 psychiatry and clinical psychology
10.1101/2025.02.10.25322034 medRxiv
Show abstract

We use connectome modelling to map polysynaptic fibre pathways underlying TMS therapy for depression. We propose putative cortical and subcortical routes connecting stimulation sites in the dorsolateral prefrontal cortex to the subgenual cingulate cortex via intermediate regions, and show route length explains (i) TMS treatment response in two independent patient cohorts and (ii) the clinical efficacy of fMRI-guided TMS targeting. Our results illuminate the neuroanatomical basis of TMS therapy for depression.

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