Premium
Predictors of response to synchronized transcranial magnetic stimulation for major depressive disorder
Author(s) -
Philip Noah S.,
Leuchter Andrew F.,
Cook Ian A.,
Massaro Joe,
Goethe John W.,
Carpenter Linda L.
Publication year - 2019
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22862
Subject(s) - major depressive disorder , psychology , anxiety , transcranial magnetic stimulation , antidepressant , depression (economics) , somatization , clinical psychology , medicine , psychiatry , stimulation , mood , neuroscience , economics , macroeconomics
Background Synchronized transcranial magnetic stimulation (sTMS) is a new modality to reduce symptoms of major depressive disorder (MDD). sTMS uses rotating neodymium magnets to deliver low‐field stimulation matched to the individual alpha frequency (IAF). A previous multisite study showed that sTMS significantly reduced MDD symptoms in the per‐protocol sample. To this end, we evaluated clinical features associated with optimal sTMS outcomes. Methods Using the per‐protocol sample ( n = 120) from the parent sham‐controlled trial, we 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 also was examined. Candidate variables included age, sex, comorbid anxiety, number of failed antidepressants in the current depressive episode, MDD severity (17‐item Hamilton Depression Rating Scale; HAMD17), anxiety symptom severity (HAMD17 anxiety/somatization factor), and IAF. Results We found that greater baseline depressive ( p < 0.001) and anxiety ( p < 0.001) symptom severity were associated with better response to active sTMS, whereas fewer failed antidepressant trials predicted superior response to sham ( p < 0.001). 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 ( p = 0.001). Conclusions Participants with greater severity of depression and higher anxiety had superior responses to active sTMS, whereas treatment naïve individuals exhibited a greater response to sham. These results lend support to the primary efficacy findings, and support further investigation of sTMS as a therapeutic noninvasive brain stimulation modality.