Unilateral and bilateral theta burst stimulation for treatment-resistant depression: Follow up on a naturalistic observation study.

Autor: Elnazali M; Lawson Health Research Institute, London, ON, Canada., Veerakumar A; Dept of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Blair M; Lawson Health Research Institute, London, ON, Canada; Research & Academics Dept, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada., Pearce EL; Lawson Health Research Institute, London, ON, Canada., Kim N; Lawson Health Research Institute, London, ON, Canada., Sebastian S; Lawson Health Research Institute, London, ON, Canada., Santo JB; Dept of Psychology, University of Nebraska Omaha, USA., Rybak YE; Dept of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Burhan AM; Dept of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: burhana@ontarioshores.ca.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2024 Dec; Vol. 180, pp. 387-393. Date of Electronic Publication: 2024 Nov 01.
DOI: 10.1016/j.jpsychires.2024.10.031
Abstrakt: Objectives: Theta burst stimulation (TBS) is a novel and faster modality of transcranial magnetic stimulation, which is showing promise as a treatment-resistant depression (TRD) treatment. Though TBS can be applied unilaterally or bilaterally, few studies have compared the effectiveness of both approaches in a naturalistic clinical sample. In this retrospective chart review, we aimed to: (1) replicate previous bilateral sequential TBS effectiveness in a larger cohort of patients at a single centre, (2) present treatment outcome data between unilateral and bilateral TBS approaches, (3) investigate baseline factors associated with our observed outcomes, and (4) examine the sustainability of response, with follow-up data up to 6 months from patients.
Methods: We included 161 patients who received TBS (unilateral: n = 64 (40%), 45.55 ± 14.25 years old, 55% females; bilateral: n = 97 (60%), 47.67 ± 15.11 years old, 58% females).
Results: Firstly, we observed 47% response and 34% remission in the bilateral group, replicating findings from a smaller naturalistic study from our group; patients receiving unilateral TBS displayed 36% response and 26% remission, with no significant differences found between unilateral and bilateral TBS in remission and response rates. Secondly, bilaterally stimulated patients needed fewer treatments than those stimulated unilaterally (27 vs 29 on average respectively, t [159] = 3.31, p = .001), and had significantly lower anxiety symptoms post treatment (GAD-7) relative to patients receiving unilateral stimulation, F (1,148) = 3.95, p = .049. Thirdly, no baseline factors were found to predict treatment outcomes. Lastly, after six months, 69% of patients who met the response criteria did not require additional treatment or a change in medication.
Conclusions: Our findings support the efficacy and tolerability of TBS in TRD and indicate that bilateral TBS may have a superior anxiolytic effect and offer a slightly faster time to response.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mariam Elnazali and Mervin Blair report financial support was provided by St. Joseph's Health Care Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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