Fig. 5. Causal inhibitory influence of the left dlPFC on the amygdalae and right dlPFC is perturbed in patients prior to rTMS.

Concurrent TMS/fMRI response following single-pulse TMS to the a left FPCN dlPFC, or b left VAN dlPFC. TMS responses were extracted from the regions of interest identified in the resting fMRI treatment arm × time interactions displayed in Fig. 2c. Left FPCN dlPFC stimulation resulted in amygdala inhibition in healthy controls (HC), but not in patients with major depressive disorder (MDD), an abnormal pattern that was not seen in response to left VAN dlPFC stimulation. For the right dlPFC ROI, activation was seen in MDD but not HC participants, and only when the left FPCN dlPFC was stimulated.