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Predictors of Response to sTMS in Patients with MDD

Depress Anxiety; ePub 2018 Nov 27; Philip, et al

In a recent study, participants with greater severity of depression and higher anxiety had superior responses to active synchronized transcranial magnetic stimulation (sTMS), whereas treatment naïve individuals exhibited a greater response to sham. Using the per‐protocol sample (n=120) from the parent sham‐controlled trial, researchers performed univariate and stepwise linear regression to identify predictors of response after 6 weeks of sTMS. A subsample (n=83) that entered a 4‐week open/active continuation phase was also examined. Candidate variables included age, sex, comorbid anxiety, number of failed antidepressants in the current depressive episode, major depressive disorder (MDD) severity (17‐item Hamilton Depression Rating Scale; HAMD17), anxiety symptom severity (HAMD17 anxiety/somatization factor), and individual alpha frequency (IAF). Researchers found:

  • Greater baseline depressive and anxiety symptom severity were associated with better response to active sTMS, whereas fewer failed antidepressant trials predicted superior response to sham.
  • MDD severity and antidepressant resistance predicted outcomes in open/active phase sTMS; lower IAF predicted poorer response in participants who received 10 weeks of active sTMS.

Philip NS, Leuchter AF, Cook IA, Massaro J, Goethe JW, Carpenter LL. Predictors of response to synchronized transcranial magnetic stimulation for major depressive disorder. [Published online ahead of print November 27, 2018]. Depress Anxiety. doi:10.1002/da.22862.