Non-invasive brain stimulation (NIBS) approaches such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are rapidly emerging as effective and well-tolerated treatments for depression. With the most recent head-to-head studies demonstrating equivalence in clinical efficacy between rTMS, tDCS and widely used pharmaceutical antidepressants, there is urgent need for a paradigm shift towards its inclusion as a low-cost, low-risk frontline treatment for depression. Here, we provide a narrative review outlining barriers currently impeding translation of NIBS approaches into large-scale clinical use, with a view to developing a neural biomarker that could provide early stratification of patients as potential responders or non-responders. We describe how the TMS-evoked potential provides a marker of cortical excitability that could be used as a baseline predictor of whether the NIBS user will derive benefit from approaches tailored to achieve neuromodulation.

中文翻译：

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寻找可靠的神经生物标志物来预测抑郁症治疗中非侵入性脑刺激的反应

重复经颅磁刺激 (rTMS) 和经颅直流电刺激 (tDCS) 等非侵入性脑刺激 (NIBS) 方法正在迅速成为有效且耐受性良好的抑郁症治疗方法。最近的头对头研究表明，rTMS、tDCS 和广泛使用的药物抗抑郁药在临床疗效上相当，因此迫切需要进行范式转变，将其纳入低成本、低风险的抑郁症一线治疗方法。在这里，我们提供了一篇叙述性综述，概述了目前阻碍 NIBS 方法转化为大规模临床应用的障碍，以期开发一种神经生物标志物，可以将患者早期分层为潜在的反应者或无反应者。我们描述了 TMS 诱发电位如何提供皮质兴奋性标记，该标记可用作 NIBS 用户是否会从为实现神经调节而定制的方法中获益的基线预测因子。