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This study used high-resolution 7-Tesla MRI to investigate changes in resting-state functional connectivity (rs-FC) of the subgenual anterior cingulate cortex (sgACC) following a treatment series of aTMS. We hypothesized a decrease in sgACC rs-FC with key cortical regions of the default mode network (DMN), reflecting a downregulation of a network that is overactive in depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-two patients with current depression underwent 7-Tesla MRI scans before and after a two-week aTMS treatment series (24,000 pulses) targeting the left dorsolateral prefrontal cortex. Fourteen healthy participants were also scanned twice as a control group. Longitudinal changes in sgACC seed-based rs-FC were compared between groups. Furthermore, group differences were assessed at baseline and at follow-up. Exploratory correlations between longitudinal changes in sgACC rs-FC, depression severity, mindfulness, and affect were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was a reduction in rs-FC between the sgACC and bilateral precunei, and between sgACC and left frontal pole in patients receiving aTMS. At baseline, patients had increased rs\u2011FC between the sgACC and a cluster including the left precuneus and a cluster in the right superior frontal gyrus. Exploratory correlations suggest an association between sgACC-precunei rs-FC changes and mindfulness (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008, uncorrected for multiple comparisons), while no associations were found with depression severity or affect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment with aTMS is associated with a reduction in rs\u2011FC between the sgACC and the DMN. Exploratory correlations with mindfulness warrant replication in larger, independent samples.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00406-026-02355-2","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:26:11Z","timestamp":1789806371000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Accelerated TMS is associated with changes of subgenual cingulate\u2013default mode network coupling in depression: an observational 7 Tesla fMRI study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9903-8564","authenticated-orcid":false,"given":"Tobias","family":"Bracht","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Borel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Dendorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila M.","family":"Soravia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Adorjan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Walther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Federspiel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Wiest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca A.","family":"Florineth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklaus","family":"Denier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"2355_CR1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1001\/jamapsychiatry.2022.3860","volume":"80","author":"J Lundberg","year":"2023","unstructured":"Lundberg J, Cars T, Loov SA, Soderling J, Sundstrom J, Tiihonen J et al (2023) Association of treatment-resistant depression With patient outcomes and health care resource utilization in a population-wide study. 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