Accelerated TMS is associated with changes of subgenual cingulate-default mode network coupling in depression: an observational 7 Tesla fMRI study.

Brain connectivity changed after accelerated TMS, but those changes were not associated with depression-severity improvement. The study helps refine mechanism questions rather than establish a response marker.

Bracht T, Borel P, Dendorfer S, Soravia LM, Adorjan K, Walther S, Federspiel A, Wiest R, Florineth GA, Denier N.
European archives of psychiatry and clinical neuroscience · Publication date: 2026-09-19
Added to site: 2026-09-25
DOI: 10.1007/s00406-026-02355-2

Electronic publication date verified in Europe PMC; first indexed 2026-09-20. This source date is separate from the site's addition date.

Modalities

Accelerated TMS, 7-Tesla fMRI

Clinical focus

Depression, Default mode network, Treatment mechanisms

Population

Adults with current depression; healthy participants provided two-scan comparison data

Sample

22 patients with current depression and 14 healthy participants

Intervention / method

Two-week accelerated TMS series totaling 24,000 pulses over the left dorsolateral prefrontal cortex, with 7-Tesla resting-state fMRI before and after treatment

Comparator

Within-patient pre-post change and repeated scans in healthy participants; no sham treatment group

Clinician summary

Subgenual cingulate connectivity with bilateral precuneus and left frontal pole decreased after treatment. An exploratory mindfulness association was uncorrected for multiple comparisons, and no association was found with depression severity or affect.

How to interpret the findings

Small observational sample without sham treatment, so time, expectancy and nonspecific treatment effects cannot be separated. Exploratory correlations were uncorrected, and the connectivity result did not track clinical symptom change. Pulse schedule, adverse events, funding and conflicts were unavailable in the checked abstract.

Equipment and disclosures

TMS and 7-Tesla MRI models were not reported in the checked abstract.

Funding and competing-interest details were not available in the checked indexed record.

Related evidence

Compare findings from the same clinical area, including mixed results.

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• TMS-EEG Correlate of Suicidal Ideation in Individuals with Depression: A Multi-Site Synthesis. · Positive with limitations
• Motor Cortex rTMS Alleviates Pain and Comorbid Depression After Spinal Cord Injury with a Correlate in M1 Intracortical Inhibition. · Positive with limitations
• A PRISMA-compliant Systematic Review and Meta-Analysis of the Late Positive Potential in Depression. · Positive with limitations
• Feasibility, tolerability, and preliminary effectiveness of an accelerated bilateral intermittent theta-burst stimulation protocol in adults with posttraumatic stress disorder and comorbid depressive disorder following mild traumatic brain injury. · Positive with limitations
• Identifying poor responders to repetitive transcranial magnetic stimulation using structural brain networks. · Positive with limitations
• Theta burst stimulation with 80 and 120% resting motor threshold do not differ in their antidepressant efficacy: a retrospective analysis. · Positive with limitations
• TMS-Evoked Cortical Reactivity Signatures as a Multidimensional Biomarker of Depression: A TMS-EEG Meta-Analysis from Diagnosis to Prognosis. · Positive with limitations
• The effects of cognitive-behavioural therapy (CBT) on heart rate variability (HRV) in people with depression and/or anxiety disorders: A systematic review and meta-analysis · Positive with limitations