Figure 9. Changes in cerebral blood flow after rTMS for treatment of depression.

The figure shows the significant increases in absolute regional cerebral blood flow (rCBF), relative to the pretreatment baseline, 72 hours after 2 weeks of 20-Hz rTMS at 100% of motor threshold over the left prefrontal cortex in a group of 10 depressed patients. A statistical parametric map shows voxels that occur within significant clusters and is color coded according to their raw p value. Increases in rCBF are displayed with a red– orange–yellow color scale. The number in the top right corner of each horizontal section (top two rows) indicates its position in mm with respect to the anterior commissure (AC)–posterior commissure plane. Twenty-hertz rTMS resulted in widespread increases in rCBF in the following regions: prefrontal cortex (L > R), cingulate gyrus (L >> R), bilateral insula, basal ganglia, uncus, hippocampus, parahippocampus, thalamus, cerebellum, and left amygdale. (Modified with permission from Speer et al, 2000).