The superior frontal longitudinal tract: a connection between the dorsal premotor and the dorsolateral prefrontal cortices

Efficacy of non-invasive brain stimulation and neuronavigation for major depressive disorder: a systematic review and meta-analysis

INTRODUCTION

Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are increasingly used for major depressive disorder (MDD). Most tDCS and rTMS studies target the left dorsolateral prefrontal cortex, either with or without neuronavigation. We examined the effect of rTMS and tDCS, and the added value of neuronavigation in the treatment of MDD.

METHODS

A search on PubMed, Embase, and Cochrane databases for rTMS or tDCS randomized controlled trials of MDD up to 1 February 2023, yielded 89 studies. We then performed meta-analyses comparing tDCS efficacy to non-neuronavigated rTMS, tDCS to neuronavigated rTMS, and neuronavigated rTMS to non-neuronavigated rTMS. We assessed the significance of the effect in subgroups and in the whole meta-analysis with a z-test and subgroup differences with a chi-square test.

RESULTS

We found small-to-medium effects of both tDCS and rTMS on MDD, with a slightly greater effect from rTMS. No significant difference was found between neuronavigation and non-neuronavigation.

CONCLUSION

Although both tDCS and rTMS are effective in treating MDD, many patients do not respond. Additionally, current neuronavigation methods are not significantly improving MDD treatment. It is therefore imperative to seek personalized methods for these interventions.

Gender Differences in the Cortical Distribution of Corpus Callosum Fibers

Introduction Research on gender-based disparities in human brain structure has spanned over a century, yielding conflicting results and ongoing debate. While some studies indicate minimal distinctions, others consistently highlight differences in the corpus callosum (CC), even after accounting for average brain size. Methods Diverging from previous approaches, this study examines the morphology of the entire CC fiber rather than solely focusing on its midsagittal structure. Utilizing advanced neuroimaging techniques and generalized Q-imaging tractography, CC streamlines were constructed to assess gender differences in fractional anisotropy (FA), volume ratio, and cortical distribution. Student's t-test was employed to examine the disparities in FA between gender groups, while gender-based distinctions in the normalized volume of the CC and its segments were assessed using analysis of covariance (ANCOVA), with absolute whole white matter volume serving as a covariate. Results No significant gender-based disparities were found in either FA or normalized CC volume. While females exhibited consistently larger normalized volume CC streamlines than males, these differences lost statistical significance after adjusting for absolute total white matter volume as a covariate. Nonetheless, CC streamlines in females displayed a broader spatial distribution, encompassing various cortical regions, including the bilateral prefrontal cortex (medial and lateral surfaces), as well as medial parietal and temporal regions. Conclusion This study elucidates gender-related variations in the morphology of the brain's white matter pathways, indicating a more widespread cortical distribution of CC fibers in females compared to males. However, the study underscores the need for further investigations into connectivity patterns to fully elucidate these gender-based disparities.