Differential symptom cluster responses to repetitive transcranial magnetic stimulation treatment in depression.

Autor:	Kaster TS; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Psychiatry, University of Toronto, Toronto, Canada.; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada., Downar J; Department of Psychiatry, University of Toronto, Toronto, Canada.; Institute of Medical Science, University of Toronto, Toronto, ON, Canada., Vila-Rodriguez F; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.; Non-Invasive Neurostimulation Therapies (NINET) Laboratory, University of British Columbia, Vancouver, BC, Canada., Baribeau DA; Department of Psychiatry, University of Toronto, Toronto, Canada.; Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, ON, Canada., Thorpe KE; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Daskalakis ZJ; Department of Psychiatry, University of California, San Diego Health, CA, United States., Blumberger DM; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Psychiatry, University of Toronto, Toronto, Canada.; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.
Jazyk:	angličtina
Zdroj:	EClinicalMedicine [EClinicalMedicine] 2022 Dec 02; Vol. 55, pp. 101765. Date of Electronic Publication: 2022 Dec 02 (Print Publication: 2023).
DOI:	10.1016/j.eclinm.2022.101765
Abstrakt:	Background: Repetitive transcranial magnetic stimulation (rTMS) can target specific neural circuits, which may allow for personalized treatment of depression. Treatment outcome is typically determined using sum scores from validated measurement scales; however, this may obscure differential improvements within distinct symptom domains. The objectives for this work were to determine: (1) whether a standard depression measure can be represented using a four symptom cluster model and (2) whether these symptom clusters had a differential response to rTMS treatment. Methods: Data were obtained from two multi-centre randomized controlled trials of rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC) for participants with treatment-resistant depression (TRD) conducted in Canada (THREE-D [Conducted between Sept 2013, and Oct 2016] and CARTBIND [Conducted between Apr 2016 and Feb 2018]). The first objective used confirmatory factor analytic techniques, and the second objective used a linear mixed effects model. Trial Registration: NCT01887782, NCT02729792. Findings: In the total sample of 596 participants with TRD, we found a model consisting of four symptom clusters adequately fit the data. The primary analysis using the THREE-D treatment trial found that symptom clusters demonstrated a differential response to rTMS treatment (F(3,5984) = 31.92, p < 0.001). The anxiety symptom cluster was significantly less responsive to treatment than other symptom clusters (t(6001) = -8.02, p < 0.001). These findings were replicated using data from the CARTBIND trial. Interpretation: There are distinct symptom clusters experienced by individuals with TRD that have a differential response to rTMS. Future work will determine whether differing rTMS treatment targets have distinct patterns of symptom cluster responses with the eventual goal of personalizing rTMS protocols based on an individual's clinical presentation. Funding: Canadian Institutes of Health Research, Brain Canada. Competing Interests: JD reports research grants from 10.13039/501100000024CIHR, the 10.13039/100000025National Institute of Mental Health, 10.13039/100009408Brain Canada, the Canadian Biomarker Integration Network in Depression, the 10.13039/100008914Ontario Brain Institute, the 10.13039/100001393Wilburforce Foundation, the 10.13039/100005310Klarman Family Foundation, the 10.13039/501100019892Arrell Family Foundation and the 10.13039/501100021113Bowness Family Foundation, travel stipends from 10.13039/501100013327Lundbeck and ANT Neuro, in-kind equipment support for investigator-initiated trials from MagVenture, and is an advisor for BrainCheck, TMS Neuro Solutions and Restorative Brain Clinics and is co-founder of Ampa Health. FVR receives research support from 10.13039/501100000024CIHR, 10.13039/100009408Brain Canada, 10.13039/501100000245Michael Smith Foundation for Health Research, 10.13039/501100008002Vancouver Coastal Health Research Institute and 10.13039/100012479Weston Brain Institute for investigator-initiated research. Philanthropic support from Seedlings Foundation. In-kind equipment support for this investigator-initiated trial from MagVenture. He has received honoraria for participation in advisory board for Janssen. DMB receives research support from the 10.13039/501100000024Canadian Institutes of Health Research (10.13039/501100000024CIHR), 10.13039/100000002National Institutes of Health – US (10.13039/100000002NIH), 10.13039/100009408Brain Canada Foundation and the Temerty Family through the 10.13039/100014405CAMH Foundation and the 10.13039/100016655Campbell Family Research Institute. He received research support and in-kind equipment support for an investigator-initiated study from 10.13039/100015428Brainsway Ltd. and he was the site principal investigator for three sponsor-initiated studies for Brainsway Ltd. He received in-kind equipment support from Magventure for investigator-initiated studies. He received medication supplies for an investigator-initiated trial from Indivior. He has participated in an advisory board for Janssen. He has participated in an advisory board for Welcony Inc. ZJD has received research and equipment in-kind support for an investigator-initiated study through Brainsway Inc and Magventure Inc. He is currently on the Scientific Advisory Board of Brainsway Inc. His work is supported by the 10.13039/501100000024Canadian Institutes of Health Research (10.13039/501100000024CIHR), the National Institutes of Mental Health (10.13039/100000025NIMH), 10.13039/100009408Brain Canada and the Temerty Family and Grant Family and through the Centre for Addiction and Mental Health (10.13039/100010523CAMH) Foundation and the 10.13039/100009820Campbell Institute. TSK, DAB, and KET report no competing interests. (© 2022 The Authors.)
Databáze:	MEDLINE
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