Baseline Connectivity Predicts Anxiety Improvement in Prefrontal TMS Trial

Transcranial magnetic stimulation (TMS) has become a standard intervention for patients with major depressive disorder who have failed multiple antidepressant trials [1]. Beyond its established role in treating core depressive symptoms, meta-analytic evidence supports its efficacy in addressing comorbid pathological anxiety and obsessive-compulsive symptoms [2, 3]. Clinical protocols have traditionally focused on the dorsolateral prefrontal cortex, yet researchers are increasingly exploring the dorsomedial prefrontal cortex as a potential target for specific symptom dimensions like anxiety [4, 5]. Despite these advances, the heterogeneity of patient response remains a significant challenge, leading to a search for biomarkers that can predict which individuals will achieve remission [6]. A new study investigates whether these clinical improvements are truly driven by specific changes in the targeted neural circuits or if other physiological factors are at play.