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124. Measuring Changes in Cortical Excitability Associated With Repetitive Transcranial Magnetic Stimulation Treatment for Depression: A Visual Evoked Potentials Study
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124. Measuring Changes in Cortical Excitability Associated With Repetitive Transcranial Magnetic Stimulation Treatment for Depression: A Visual Evoked Potentials Study

Alexandra Alario, Rachael Sumner, Mark Niciu and Nicholas Trapp
Biological psychiatry (1969), Vol.99(10 Supplement), pp.S152-S152
05/15/2026
DOI: 10.1016/j.biopsych.2026.03.358

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Abstract

Background Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for treatment-resistant depression (TRD), hypothesized to enhance cortical excitability and long-term potentiation (LTP) in the brain. Visual evoked potentials (VEPs) are a non-invasive and effective method to measure changes in cortical excitability and LTP. To date, no studies have assessed the effect of rTMS treatment for TRD on VEPs. Methods We measured VEPs with electroencephalography before and after a treatment course of rTMS in 17 subjects with TRD. We used the Statistical Parametric Mapping (SPM12) toolbox to identify components of interest in parietal and occipital electrodes. LTP activity was defined as a change in the VEP following visual tetanus. Patient Health Questionnaire-9 was used to measure clinical symptoms. Results The VEP plasticity task was effective at evoking and potentiating the visual evoked potentials. Following a treatment course of rTMS, the P1 and N90op amplitudes were enhanced. There was no association with antidepressant outcome and change in VEPs. Conclusions rTMS effectively potentiated VEPs, suggesting that rTMS can enhance cortical excitability and LTP activity at brain regions distal to the site of stimulation. These findings support the hypothesis that rTMS may treat TRD by modulating cortical excitability.

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