The Relationship Between Emotion Processing Assessed by an Affect Rating Task and Depression Symptoms Following the Accelerated Sequential Dorsolateral-Dorsomedial Prefrontal rTMS Treatment.

Authors

Ruiqin Chen, Zerun Dong, Ruijie Geng, Haibin Li, Yuan Wang, Yuanyuan Li, Qiong Ding, Yingying Zhang, Xuechen Ding, Jingjing Huang, Hui Zhao, Wenjuan Liu, Valerie Voon, Yi-Jie Zhao

Published in

Behavioral sciences (Basel, Switzerland). Volume 16. Issue 2. Jan 26, 2026. Epub Jan 26, 2026.

Abstract

Emotion processing is critical in the neuropathology of major depressive disorder (MDD), while its relationship with clinical treatment remains unclear. This study aims to indicate the associations between emotion processing and treatment effects following a sequential dual-site accelerated repetitive transcranial magnetic stimulation (rTMS) protocol.
MDD patients were recruited to receive rTMS treatment with four sessions per day for four consecutive days, with stimulation sequentially delivered to the left dorsolateral prefrontal cortex (dlPFC) and the dorsomedial prefrontal cortex (dmPFC). Symptoms were assessed at baseline, end of treatment, and week 4 using the Montgomery-Åsberg Depression Rating Scale (MADRS), Snaith-Hamilton Pleasure Scale (SHAPS), and Fatigue Severity Scale (FSS). Emotional valence and arousal were evaluated with the Affect Rating Task (ART).
A total of 51 participants completed the clinical assessments and ART, with two excluded due to missing baseline data in the SHAPS and FSS. The linear mixed-effects models revealed significant improvement in depressive (p < 0.001, d = -0.343) and fatigue symptoms (p = 0.010, d = -0.572) following rTMS treatment. Neutral valence was correlated with MADRS scores at baseline (R² = 0.096, p = 0.027). In addition, changes in arousal for positive images (p = 0.047, adjusted R² = 0.097) and neutral images (p = 0.019, adjusted R² = 0.160) at treatment end were significantly correlated with MADRS improvement at week 4.
Our study highlights the association between changes in emotional arousal and improvement in MDD following accelerated dlPFC-dmPFC dual-site rTMS treatment.

PMID:
41749987
Bibliographic data and abstract were imported from PubMed on 13 Sep 2026.

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