{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:31:15Z","timestamp":1788237075855,"version":"build-2803163510"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the improvement effect of occipital repetitive transcranial magnetic stimulation (rTMS) combined with escitalopram oxalate tablets on pre-attentive processing in patients with first-episode, medication-naive depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who were hospitalized between January and December 2019 were selected. They were randomly allocated to real occipital rTMS stimulation group with 27 cases receiving intermittent theta-burst (iTBS) and sham stimulation group with 24 cases over 20 days. The rTMS treatment target is located at the Oz point of the occipital region. Both groups took escitalopram oxalate tablets, and the average daily drug dose was 15.294 \u00b1 5.041 mg. Hamilton Depression Rating Scale (HAMD) was used to assess the symptoms of depression before and after treatment, and mismatch negativity (MMN) was used to assess the improvement of pre-attentive processing before and after treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 20 days of treatment, the total score of HAMD (13.495 \u00b1 3.700) in both groups was significantly lower than that before treatment [21.910 \u00b1 3.841,\n                      <jats:italic>F<\/jats:italic>\n                      (1, 49) = 46, 3.690,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001]. After treatment, the latency of MMN in the real stimulation group (182.204 \u00b1 31.878 ms) was significantly lower than that in the sham stimulation group (219.896 \u00b1 42.634 ms,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), and the amplitude of MMN in the real stimulation group (\u22127.107 \u00b1 3.374 ms) was significantly higher than that in the sham stimulation group (\u22122.773 \u00b1 3.7 32 ms,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Occipital rTMS treatment can enhance the early therapeutic effect and effectively improve the pre-attentive processing of patients with depression and provide a scientific basis for the new target of rTMS therapy in clinical patients with depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnhum.2021.648816","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:13:04Z","timestamp":1623111184000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Improved Pre-attentive Processing With Occipital rTMS Treatment in Major Depressive Disorder Patients Revealed by MMN"],"prefix":"10.3389","volume":"15","author":[{"given":"Muzhen","family":"Guan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xufeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiguo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingrong","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaihai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaning","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.brs.2014.11.002","article-title":"rTMS of the dorsomedial prefrontal cortex for major depression: safety, tolerability, effectiveness, and outcome predictors for 10 Hz versus intermittent theta-burst stimulation.","volume":"8","author":"Bakker","year":"2015","journal-title":"Brain Stimul."},{"key":"B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14814\/phy2.14087","article-title":"Effects of anodal transcranial direct current stimulation on motor evoked potentials variability in humans.","volume":"7","author":"Bashir","year":"2019","journal-title":"Physiol. Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1016\/s0140-6736(18)30295-2","article-title":"Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial.","volume":"391","author":"Blumberger","year":"2018","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0560-3","article-title":"Cognitive remission:a novel objective for the treatment of major depression?","volume":"14","author":"Bortolato","year":"2016","journal-title":"BMC Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.pscychresns.2008.10.006","article-title":"The value of HMPAO SPECT in predicting treatment response to citalopram in patients with major depression.","volume":"173","author":"Brockmann","year":"2009","journal-title":"Psychiatry Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.neulet.2010.01.050","article-title":"Dysfunction of processing task-irrelevant emotional faces in major depressive disorder patients revealed by expression-related visual MMN.","volume":"472","author":"Chang","year":"2010","journal-title":"Neurosci. Lett."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.00245","article-title":"State-related alterations of spontaneous neural activity in current and remitted depression revealed by resting-state fMRI.","volume":"10","author":"Cheng","year":"2019","journal-title":"Front. Psychol."},{"key":"B8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/gps.4726","article-title":"Effects of repetitive transcranial magnetic stimulation on improvement of cognition in elderly patients with cognitive impairment: a systematic review and meta-analysis.","volume":"33","author":"Cheng","year":"2018","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.biopsych.2013.10.026","article-title":"Anhedonia and reward-circuit connectivity distinguish nonresponders from responders to dorsomedial prefrontal repetitive transcranial magnetic stimulation in major depression.","volume":"76","author":"Downar","year":"2014","journal-title":"Biol. Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2015.00210","article-title":"Rethinking the role of sham TMS.","volume":"6","author":"Duecker","year":"2015","journal-title":"Front. Psychol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.bpsc.2017.12.003","article-title":"Abnormal functional connectivity of frontopolar subregions in treatment-nonresponsive major depressive disorder.","volume":"3","author":"Fettes","year":"2018","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"B12","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jocn.2019.02.007","article-title":"Is occipital bending a structural biomarker of risk for depression and sensitivity to treatment?","volume":"63","author":"Fullard","year":"2019","journal-title":"J. Clin. Neurosci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.clinph.2008.11.029","article-title":"The mismatch negativity: a review of underlying mechanisms.","volume":"120","author":"Garrido","year":"2009","journal-title":"Clin. Neurophysiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jad.2019.07.065","article-title":"State-independent and -dependent structural alterations in limbic-cortical regions in patients with current and remitted depression.","volume":"258","author":"Ge","year":"2019","journal-title":"J. Affect. Disorder"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.5578","article-title":"Association of Repetitive transcranial magnetic stimulation treatment with subgenual cingulated hyperactivity in patients with major depressive disorder: a secondary analysisof a randomized clinical trial.","volume":"26","author":"Hadas","year":"2019","journal-title":"JAMA Netw. Open."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2016\/9674790","article-title":". Adaptive plasticity in the healthy language network: implications for language recovery after stroke.","volume":"2016","author":"Hartwigsen","year":"2016","journal-title":"Neural Plast."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.583268","article-title":"Differentiating responders and Non-responders to rTMS treatment for disorder of consciousness using EEG after-effects.","volume":"11","author":"He","year":"2020","journal-title":"Front. Neurol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.pnpbp.2009.12.021","article-title":"Mismatch negativity in treatment-resistant depression and borderline personality disorder.","volume":"34","author":"He","year":"2010","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12984-015-0036-2","article-title":"The coil orientation dependency of the electric field induced by TMS for M1 and other brain areas.","volume":"12","author":"Janssen","year":"2015","journal-title":"J. Neuroeng. Rehabil."},{"key":"B20","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1111\/ejn.12061","article-title":"Visual mismatch negativity is sensitive to symmetry as a perceptual category.","volume":"37","author":"Kecskes-Kovdes","year":"2013","journal-title":"Eur. J. Neurosci."},{"key":"B21","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.schres.2017.09.045","article-title":"Association between mismatch negativity and global functioning is specific to duration deviance in early stages of psychosis.","volume":"195","author":"Koshiyama","year":"2018","journal-title":"Schizophr. Res."},{"key":"B22","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.jad.2018.01.017","article-title":"Altered neural processing of reward and punishment in adolescents with major depressive disorder.","volume":"232","author":"Landes","year":"2018","journal-title":"J. Affect. Disorder"},{"key":"B23","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.jad.2011.10.023","article-title":"A meta-analysis of cognitive deficits in first-episode major depressive disorder.","volume":"140","author":"Lee","year":"2012","journal-title":"J. Affect. Disorder"},{"key":"B24","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.cpr.2018.06.008","article-title":"Depression: a cognitive perspective.","volume":"69","author":"LeMoult","year":"2019","journal-title":"Clin. Psychol. Rev."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1654-6","article-title":"Towards characterizing the regional cerebral perfusion in evaluating the severity of major depression disorder with SPECT\/CT.","volume":"18","author":"Li","year":"2018","journal-title":"BMC Psychiatry"},{"key":"B26","first-page":"1545","article-title":"Clinical study of event-related potentials in patients with depression.","volume":"12","author":"Li","year":"2020","journal-title":"Hainan. Med. J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"97","DOI":"10.2174\/1573400511208020097","article-title":"Auditory and visual mismatch negativity in psychiatric disorders: a review.","volume":"8","author":"Maekawa","year":"2012","journal-title":"Curr. Psychiatry Rev."},{"key":"B28","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.brainres.2012.07.016","article-title":"Impact of lower-vs. upper-hemifield presentation on automatic colour-deviance detection: a visual mismatch negativity study.","volume":"1472","author":"Maller","year":"2012","journal-title":"Brain Res."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1093\/brain\/awu072","article-title":"Occipital bending in depression.","volume":"137","author":"Maller","year":"2014","journal-title":"Brain"},{"key":"B30","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/j.1469-8986.2009.00856.x","article-title":"Mismatch negativity (MMN), the deviance-elicited auditory deflection, explained.","volume":"47","author":"May","year":"2010","journal-title":"Psychophysiology"},{"key":"B31","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.jad.2016.01.028","article-title":"Pre-attentive dysfunction of musical processing in major depressive disorder: a mismatch negativity study.","volume":"194","author":"Mu","year":"2016","journal-title":"J. Affect. Disorder"},{"key":"B32","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/j.ijpsycho.2014.12.012","article-title":"Mismatch negativity (MMN) deficiency: a break-through biomarker in predicting psychosis onset.","volume":"95","author":"N\u00e4\u00e4t\u00e4nen","year":"2015","journal-title":"Int. J. Psychophysiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.jad.2012.03.026","article-title":"Assessment of cerebral blood flow findings using 99mTc-ECD single-photon emission computed tomography in patients diagnosed with major depressive disorder.","volume":"140","author":"Nagafusa","year":"2012","journal-title":"J. Affect. Disorder"},{"key":"B34","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jad.2011.12.028","article-title":"Reduced temporal mismatch negativity in late-life depression: an event-related potential index of cognitive deficit and functional disability?","volume":"138","author":"Naismith","year":"2012","journal-title":"J. Affect. Disorder"},{"key":"B35","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/s0006-3223(02)01548-2","article-title":"Regional cerebral blood flow in depressed patients with white matter magnetic resonance hyperintensity.","volume":"53","author":"Oda","year":"2003","journal-title":"Biol. Psychiatry"},{"key":"B36","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1038\/nrdp.2016.65","article-title":"Major depressive disorder.","volume":"2","author":"Otte","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"B37","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.jad.2016.04.001","article-title":"Essential brain structural alterations in major depressive disorder: a voxel-wise meta-analysis on first episode, medication-na\u00efve patients.","volume":"199","author":"Peng","year":"2016","journal-title":"J. Affect. Disorder"},{"key":"B38","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.pscychresns.2012.07.006","article-title":"Impaired pre-attentive change detection in major depressive disorder patients revealed by auditory mismatch negativity.","volume":"211","author":"Qiao","year":"2013","journal-title":"Psychiatry Res."},{"key":"B39","doi-asserted-by":"publisher","first-page":"503","DOI":"10.4103\/0973-1296.141775","article-title":"Changes in regional cerebral blood flow with Chaihu-Shugan-San in the treatment of major depression.","volume":"10","author":"Qiu","year":"2014","journal-title":"Pharmacogn. Mag."},{"key":"B40","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.jad.2017.11.043","article-title":"Pattern recognition of magnetic resonance imaging-based gray matter volume measurements classifies bipolar disorder and major depressive disorder.","volume":"2","author":"Rubin-Falcone","year":"2018","journal-title":"J. Affect. Disorder"},{"key":"B41","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1016\/j.jad.2018.09.021","article-title":"Aberrant cortical neurodevelopment in major depressive disorder.","volume":"243","author":"Schmitgen","year":"2019","journal-title":"J. Affect. Disorder"},{"key":"B42","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.brs.2017.11.002","article-title":"Number of pulses or number of sessions? An open-label study of trajectories of improvement for once- vs. twice-daily dorsomedial prefrontal rTMS in major depression.","volume":"11","author":"Schulze","year":"2018","journal-title":"Brain Stimul."},{"key":"B43","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.nicl.2016.08.016","article-title":"Changes of grey matter volume in first-episode drug-naive adult major depressive disorder patients with different age-onset.","volume":"12","author":"Shen","year":"2016","journal-title":"Neuroimage Clin."},{"key":"B44","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.brs.2013.07.004","article-title":"Antidepressant efficacy of high and low frequency rTMS at 110% of motor threshold versus sham stimulation over left prefrontal cortex.","volume":"7","author":"Speer","year":"2014","journal-title":"Brain Stimul."},{"key":"B45","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1016\/j.jad.2020.05.140","article-title":"Attentional biases to emotional information in clinical depression: a systematic and meta-analytic review of eye tracking findings.","volume":"274","author":"Suslow","year":"2020","journal-title":"J. Affect. Disorders"},{"key":"B46","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1097\/yct.0000000000000477","article-title":"How does repetitive transcranial magnetic stimulation influence the brain in depressive disorders?: a review of neuroimaging magnetic resonance imaging studies.","volume":"34","author":"Taib","year":"2018","journal-title":"J. ECT"},{"key":"B47","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.clinph.2006.09.001","article-title":"Measurement of extensive auditory discrimination profiles using the mismatch negativity (MMN) of the auditory event-related potential (ERP).","volume":"118","author":"Takegata","year":"2006","journal-title":"Clin. Neurophysiol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1177\/1094428118804657","article-title":"Primer on electroencephalography and event- related potentials for organizational neuroscience.","volume":"22","author":"Tivadar","year":"2019","journal-title":"Organ. Res. Methods"},{"key":"B49","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/S0013-7006(04)95449-8","article-title":"Transcranial magnetic stimulation in cognition and neuropsychology.","volume":"30","author":"Verdon","year":"2004","journal-title":"Encephale"},{"key":"B50","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.jad.2018.10.104","article-title":"Executive control dysfunction in subclinical depressive undergraduates: evidence from the attention network test.","volume":"245","author":"Yang","year":"2019","journal-title":"J. Affect. Disorder"},{"key":"B51","first-page":"1541","article-title":"Difference in resting-state fractional amplitude of low-frequency fluctuation between bipolar depression and unipolar depression patients.","volume":"21","author":"Yu","year":"2017","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"B52","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s00406-015-0614-0","article-title":"Altered functional connectivity density in major depressive disorder at rest.","volume":"266","author":"Zhang","year":"2016","journal-title":"Eur. Arch. Psych. Clin. Neurosci."},{"key":"B53","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.jad.2019.01.048","article-title":"Intrinsic gray-matter connectivity of the brain in major depressive disorder.","volume":"251","author":"Zhang","year":"2019","journal-title":"J. Affect. Disorder"},{"key":"B54","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.neubiorev.2015.10.011","article-title":"Brain gray matter alterations in first episodes of depression: a meta-analysis of whole-brain studies.","volume":"60","author":"Zhang","year":"2016","journal-title":"Neurosci. Biobehav. Rev."},{"key":"B55","first-page":"1","article-title":"Task-related functional magnetic resonance imaging-based neuronavigation for the treatment of depression by individualized repetitive transcranial magnetic stimulation of the visual cortex.","volume":"63","author":"Zhang","year":"2020","journal-title":"Sci. China"}],"container-title":["Frontiers in Human Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2021.648816\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T11:27:27Z","timestamp":1624274847000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2021.648816\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,8]]},"references-count":55,"alternative-id":["10.3389\/fnhum.2021.648816"],"URL":"https:\/\/doi.org\/10.3389\/fnhum.2021.648816","relation":{},"ISSN":["1662-5161"],"issn-type":[{"value":"1662-5161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,8]]},"article-number":"648816"}}