Prefrontal lobe and depression.

In recent years, a lot of researchers have increasingly linked the dysfunction of the prefrontal lobe to depression. The prefrontal lobe is the area that lies at the front of the brain, responsible for controlling high-level human functions. The following are indicative:

• Behavior adjustment
• Regulation of emotional expression
• Attention & Concentration
• Creativity
• Design
• Prioritization
• Problem solving
• Decision making
• Judgement
• Learning from experience
• Social behavior
• Inhibition

In a significant percentage of cases of depression, there is a dysfunction of the above functions. Specifically, studies that have been conducted using neuroimaging methods such as fMRI (Functional Magnetic Resonance Imaging), showed reduced or increased activation in specific areas of the prefrontal lobe.

For example, a relatively stable finding is the presence of reduced activation in the dorsolateral part of the prefrontal cortex (DLPFC) and correspondingly increased activation has been observed in the ventromedial part of the prefrontal cortex (VMPFC). And indeed, the ventromedial part which is linked with the depressed mood is the one that has a direct neural connection with the limbic system and especially areas related to emotion such as the amygdala. The dorsolateral part is the one that when dysfunctions, the person experiences loss of motivation and interests, apathy, thoughtlessness as well as inactivity.

An even more specific finding is the differentiation of the left from the right prefrontal cortex. Research data that also highlight the contribution of repetitive transcranial magnetic stimulation (rTMS) suggest that left frontal cortex dysfunctions and right frontal cortex hyperfunctions in depression. This finding also provides the theoretical background for the basic use of rTMS in the treatment of depression through intervention in the prefrontal cortex. The application of a high-frequency magnetic field to the left prefrontal cortex of the brain has a stimulating therapeutic effect, reversing its dysfunction. Similarly, the application of a lower frequency magnetic field to the right prefrontal cortex has an inhibitory therapeutic effect, reversing its hyperfunction. Both rTMS protocols have equally confirmed therapeutic potential.

In conclusion, the combined use of new knowledge of neurobiology, neurophysiology and neuroanatomy of the brain in parallel with the development of medical technology “opens a window” for the most effective treatment of depression and other disorders in the medium term.

Σπύρος Καλημέρης Ψυχίατρος Ψυχοθεραπευτής

Spiros Kalimeris Psychiatrist Psychotherapist
#rtms #depression #rtmstreatment