The therapeutic potential of personalized connectivity-guided transcranial magnetic stimulation target over group-average target for depression

Repetitive transcranial magnetic stimulation (rTMS) has been widely used to treat the major depressive disorder (MDD) with a common target over the left dorsolateral prefrontal cortex (DLPFC) [1]. Studies have shown that the left DLPFC targets with better antidepressant efficacy were more negatively correlated with the subgenual cingulate cortex (sgACC), suggesting rTMS efficacy might be improved via functional connectivity (FC)-guided targeting [2–4]. A multi-site rTMS study using the group-average DLPFC target, defined as the most negative FC with sgACC from a cohort of healthy controls, reported a high response rate of 49% in MDD [5].