Depressive symptom trajectories with prolonged rTMS treatment.

Autor: Chen X; CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China; Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, 100101, China., Blumberger DM; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, M5T1R8, Ontario, Canada., Downar J; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, M5T1R8, Ontario, Canada., Middleton VJ; Salience Health Solutions, Plano, 75024, Texas, USA., Monira N; Salience Health Solutions, Plano, 75024, Texas, USA., Bowman J; Salience Health Solutions, Plano, 75024, Texas, USA., Kriske J; Salience Health Solutions, Plano, 75024, Texas, USA., Kriske J; Salience Health Solutions, Plano, 75024, Texas, USA., Donachie N; Salience Health Solutions, Plano, 75024, Texas, USA., Kaster TS; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, M5T1R8, Ontario, Canada. Electronic address: tyler.kaster@camh.ca.
Jazyk: angličtina
Zdroj: Brain stimulation [Brain Stimul] 2024 May-Jun; Vol. 17 (3), pp. 525-532. Date of Electronic Publication: 2024 Apr 18.
DOI: 10.1016/j.brs.2024.04.010
Abstrakt: Background: A prolonged repetitive transcranial magnetic stimulation (rTMS) treatment course could be beneficial for some patients experiencing major depressive episodes (MDE). We identified trajectories of rTMS response in depressive patients who received an extended rTMS treatment course and sought to determine which trajectories achieved the greatest benefit with a prolonged treatment course.
Method: We applied group-based trajectory modeling to a naturalistic dataset of depressive patients receiving a prolonged course of sequential bilateral rTMS (up to 51 treatment sessions) to the dorsolateral prefrontal cortex. Trajectories of the PHQ-9 with extended treatment courses were characterized, and we explored the association between baseline clinical characteristics and group membership using multinomial logistic regression.
Results: Among the 324 study participants, four trajectories were identified: "linear response, extended course" (N = 73; 22.5 %); "nonresponse" (N = 23; 7.1 %); "slowed response" (N = 159; 49.1 %); "rapid response, standard treatment length" (N = 69; 21.3 %). Only the "linear response, extended course" group showed considerable clinical improvement after receiving additional rTMS treatments. Greater baseline depressive symptoms were associated with linear response and non-response.
Conclusion: Our results confirmed the distinctive response trajectories in depressive patients receiving rTMS and further highlighted that prolonged rTMS treatment courses may be beneficial for a subset of patients with higher initial symptom levels and linear early treatment response.
Competing Interests: Declaration of competing interest Xiao Chen has received research support from the National Natural Science Foundation of China, the China Scholarship Council, and the Chinese Academy of Sciences. Daniel M. Blumberger has received research support from CIHR, NIH, Brain Canada, and the Temerty Family through the CAMH Foundation and the Campbell Family Research Institute. He received research and in-kind equipment support for an investigator-initiated study from Brainsway Ltd. He is the site principal investigator for three sponsor-initiated studies for Brainsway Ltd. He also receives in-kind equipment support from Magventure for investigator-initiated research. He received medication supplies for an investigator-initiated trial from Indivior. Jonathan Downar has received research support from NIH, CIHR, Brain Canada, Ontario Brain Institute, the Klarman Family Foundation, the Krembil Foundation, Arrell Family Foundation, and the Buchan Family Foundation, in-kind equipment support for investigator-initiated trials from MagVenture, is an advisor for BrainCheck, Arc Health Partners and Salience Neuro Health, and is a co-founder of Ampa Health. Tyler S. Kaster is supported by the Canadian Institute for Health Research and the AFP Innovation Fund. Study data was provided at no cost by Salience Health. No funding was provided for the analysis, or manuscript creation. Victoria J. Middleton, Naima Monira, Jennifer Bowman, Joseph Kriske, John Kriske, and Nancy Donachie are employees of Salience Health.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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