Intermittent Theta Burst Stimulation of the Dorsomedial PFC and Expectancy-Driven Placebo Mood Effects

Can neuromodulation harness antidepressant placebo effects by potentiating default mode network (DMN) activity?In this within-person randomized clinical trial of 50 adults with depressive symptoms and not taking psychotropic medication, intermittent theta burst stimulation (iTBS) significantly increased DMN activation during antidepressant expectancy cues compared with continuous TBS, following a monotonic pattern across conditions. Greater activation under iTBS was associated with larger expectancy-driven mood improvements.Results show that DMN potentiation can causally amplify placebo-induced mood improvement, demonstrating that antidepressant placebo effects can be systematically enhanced through targeted brain stimulation.

Corresponding Author: Marta Peciña, MD, PhD, University of Pittsburgh, 100 N Bellefield Ave, Room 746, Pittsburgh, PA 15208 (pecinam@upmc.edu).

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