Major depressive disorder (MDD) remains one of the world’s most disabling mental illnesses, and while transcranial magnetic stimulation (TMS) is an FDA-approved treatment, its effectiveness varies widely between individuals. Now, a team from the Institute of Psychology, Chinese Academy of Sciences and the Tsinghua University has published a breakthrough study in Science Bulletin that may help change that.
The team used resting-state functional MRI data from 1,660 patients with depression and 1,341 healthy controls collected through the Depression Imaging REsearch ConsorTium (DIRECT) Phase II. They systematically mapped abnormalities in the brain’s subgenual anterior cingulate cortex (sgACC) connectivity—a region repeatedly implicated in depression—and its interaction with the left dorsolateral prefrontal cortex (DLPFC), the standard target of TMS treatment. This massive dataset has been made public ( https://rfmri.org/DIRECTPhase2 ), providing an unprecedented, rich, and high-quality repertoire for the global research community. The team welcomes colleagues from both domestic and international institutions to utilize the dataset to further explore the neural mechanisms of depression, conduct cross-group replication studies, develop innovative methodologies, and advance clinical translational research, promoting open science and a new paradigm of large-scale collaborative efforts.
Crucially, the researchers found that abnormal sgACC–DLPFC connectivity patterns influenced both the anatomical location of optimal TMS targets and patient outcomes. Building on this, they proposed a novel algorithm that integrates large-scale group-level statistical maps with individual brain data using dual regression. This “MDD big data-guided individualized TMS targeting algorithm” was validated in three independent clinical datasets, including patients with treatment-resistant depression and suicidal ideation.
Compared to conventional “group average” or anatomical targeting methods, this individualized approach produced targets more closely associated with symptom improvement, suggesting a major step forward for precision psychiatry.
Science Bulletin
Observational study