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Abstracts from the International Congress of Parkinson’s and Movement Disorders.

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Neural Mechanisms of Intermittent Theta Burst Stimulation for Depressive Symptoms in Parkinson’s Disease: Insights from fNIRS-Based Cortical Activation and Connectivity Dynamics

Y. Zhang, M. Hou, Z. Liu (Shanghai, China)

Meeting: 2025 International Congress

Keywords: Depression, Neurostimulation, Transcranial magnetic stimulation(TMS)

Category: Parkinson’s Disease: Clinical Trials

Objective: This study investigated the neural mechanisms underlying the effects of intermittent theta burst stimulation (iTBS) on depressive symptoms in Parkinson’s disease (PD-D) using functional Near-Infrared Spectroscopy (fNIRS).

Background: Depressive symptoms are prevalent in Parkinson’s disease (PD), yet effective management remains challenging. iTBS, a novel repetitive transcranial magnetic stimulation (rTMS) technique, shows promise but lacks validation in PD-D patients.

Method: A verbal fluency task (VFT) was performed by 35 PD-D and 25 PD patients without depressive symptoms (PD-ND) to assess cortical activation and dynamic functional connectivity via fNIRS. Based on HAM-D-24 scores, 28 PD-D patients (verum group: N=17; sham group: N=11) underwent 10 sessions of iTBS or sham stimulation targeting the left dorsolateral prefrontal cortex (DLPFC) over two weeks. Depressive and anxiety symptoms were assessed at the 5th and 10th sessions and one month post-intervention. A second fNIRS scan was conducted after the final session to evaluate changes in cortical activation and connectivity dynamics.

Results: PD-D patients exhibited significant hypoactivation in Ch30 and a higher likelihood of transitioning to connectivity states with reduced information transmission during the VFT compared to PD-ND patients. These neural alterations correlated with depression severity. Following 10 iTBS sessions, the verum group demonstrated significant and sustained improvements in depressive and anxiety symptoms compared to the sham group. Enhanced cortical activation and normalized connectivity dynamics were observed in the verum group during the post-intervention fNIRS assessment.

Conclusion: iTBS over the left DLPFC effectively alleviates depressive symptoms in PD-D by restoring cortical activation and rebalancing functional connectivity dynamics.

To cite this abstract in AMA style:

Y. Zhang, M. Hou, Z. Liu. Neural Mechanisms of Intermittent Theta Burst Stimulation for Depressive Symptoms in Parkinson’s Disease: Insights from fNIRS-Based Cortical Activation and Connectivity Dynamics [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/neural-mechanisms-of-intermittent-theta-burst-stimulation-for-depressive-symptoms-in-parkinsons-disease-insights-from-fnirs-based-cortical-activation-and-connectivity-dynamics/. Accessed November 20, 2025.
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