Long-Term Follow-Up of Adolescents With Resistant Depression Treated With Repetitive Transcranial Magnetic Stimulation

Mayer, Gad; Aviram, Shai; Walter, Garry; Levkovitz, Yechiel; Bloch, Yuval

doi:10.1097/yct.0b013e318238f01a

Cited by 39 publications

(23 citation statements)

References 5 publications

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“…From the same sample, 8 of these study participants were followed for 3 years, and found that no cognitive deterioration occurred and some subjects maintained clinical improvement after treatment [51]. Wall et al [52] followed 7 of 8 adolescents in an open trial of rTMS for 6 months, and found rTMS to be safe and was the preferred treatment over medication for the majority of patients and their parents.…”

Section: Repetitive Transcranial Magnetic Stimulation (Rtms)mentioning

confidence: 99%

Treatment-Resistant Depression in Adolescents: A Comprehensive Review

Carandang¹

2013

J Depress Anxiety

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disorder due to a general medical condition (including substanceinduced depression). Detailed information on the clinical assessment of children and adolescents with depression can be found elsewhere [13]. Other Factors Associated with Poor Treatment ResponseOther than the correct diagnosis of depression, clinicians should explore other factors which contribute to poor treatment response. Exploring other factors leading to treatment-resistant depression will also guide why a patient is not responding. Depressed adolescent patients with a history of abuse, especially physical abuse, had a poorer response to combination treatment with medication and psychotherapy [14]. These patients with a history of abuse may require specialized treatment. Adolescents with treatment-resistant depression had better treatment response if substance abuse-related impairment was low at baseline or reduced during treatment [15]. Suicidal adverse events during treatment of adolescent refractory depression were predicted by high suicidal ideations, family conflict and drug abuse at baseline. These predictors of suicidal adverse events also predict poor treatment response, and hence targeting suicidal ideations, family conflict and drug abuse can improve treatment outcomes [16]. Parent-child conflict has a bidirectional relationship with treatment outcome in adolescent treatment resistant depression [17]. Anhedonia in depressed adolescent's refractory to medication treatment predicted longer time to remission and fewer depression-free days [18]. Depression severity and subsyndromal manic symptoms predicted poor treatment response in this sample [19]. There is also suggestion that adjunctive sleep medication to SSRI treatment in this sample may be associated with poor response [20]. Interestingly, if treatment ends during school summer break, AbstractTreatment nonresponse in adolescent depression is a major public health problem, as untreated depression is associated with significant mortality by suicide, protracted course of illness, and recurrence into adulthood. Even with the gold-standard treatment with a Selective Serotonin Reuptake Inhibitor (SSRI) and concurrent Cognitive Behavioral Therapy (CBT), 30% to 40% will not respond to treatment, thus classified as "treatment-resistant". These depressed adolescent patients who are refractory to first-line treatments are often in such mental anguish that they are not functioning, and some have considered their only option left to end the misery is to suicide. These are the patients who are often referred to psychiatry, but the treatment options for adolescents with treatment-resistant depression are limited due to lack of research in this area. This review will consider the various treatment options that may help to alleviate the suffering of adolescents afflicted with this devastating illness, with the caveat that there are few controlled studies focused on refractory depression in adolescents.

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Section: Repetitive Transcranial Magnetic Stimulation (Rtms)mentioning

confidence: 99%

Treatment-Resistant Depression in Adolescents: A Comprehensive Review

Carandang¹

2013

J Depress Anxiety

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“…Gillick et al (2014a) and Mayer et al (2012) reported no serious adverse events following rTMS in children. However, long-term outcomes have not yet been reported on studies combining NIBS with motor interventions in children with hemiparesis.…”

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confidence: 99%

“…Long-term safety and efficacy is evident in CIMT (Olesch et al 2010;Eliasson and Holmefur 2015). Safety of CIMT in children is measured by monitoring for functional decline in the restrained limb and parental stress (Cope et al 2008;Fedrizzi et al 2013).…”

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confidence: 99%

“…Long-term neuromodulation safety for children with medicationresistant depression treated with rTMS was examined with a 3 year follow-up, revealing no decline in cognitive function or depressive symptoms in a small sample (n = 6) (Mayer et al 2012). Gillick et al (2014a) and Mayer et al (2012) reported no serious adverse events following rTMS in children.…”

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confidence: 99%

“…CIMT involves a restraint on the less-affected limb and incorporates neuroplasticity principles of motor learning (DeLuca et al 2003). Developmental, cognitive status, and cortical reorganization following stroke can influence individual outcomes following neuromodulation and CIMT (Bodimeade et al 2013;Carey et al 2014;Friel et al 2014;Miller et al 2015).…”

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confidence: 99%

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Repetitive Transcranial Magnetic Stimulation/Behavioral Intervention Clinical Trial: Long-Term Follow-Up of Outcomes in Congenital Hemiparesis

Rich

Menk

Krach

et al. 2016

Journal of Child and Adolescent Psychopharmacology

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Objective: The purpose of this study was to examine long-term outcomes of nonpharmacological intervention in children and adolescents with stroke utilizing repetitive transcranial magnetic stimulation (rTMS) to the primary motor cortex combined with constraint-induced movement therapy (CIMT) to improve motor function in the paretic hand. Outcome measures included function, satisfaction, and medical status review. Methods: Fourteen of the original 19 participants (74%) from our rTMS/CIMT clinical trial (real rTMS+CIMT, n = 8; and sham rTMS+CIMT, n = 6) were evaluated. The median age of the subjects at follow up was 13.4 years (range 11-20 years old, 50% male). Median time to follow-up was 47.5 months (range 21-57 months). Descriptive statistics were conducted using frequencies and counts. Motor performance was measured using the Assisting Hand Assessment (AHA) and Canadian Occupational Performance Measure (COPM). Satisfaction was reported with use of the COPM and TMS Tolerance Survey. Open-ended interview was conducted for feedback on study experience and subjective perspectives of current functional status. Results: Overall, seven of eight individuals who received real rTMS and five of six individuals who received sham rTMS maintained or improved AHA scores. Six of 14 participants reported new onset of co-occurring conditions (four individuals in the real rTMS group, two individuals in the sham rTMS group). The majority (86%) of participants reported study satisfaction. Review of medical status revealed co-occurring conditions including: Epilepsy, obsessive-compulsive disorder, anxiety, depression, unspecified mood disorder, and undiagnosed inattentiveness. Conclusions: Long-term outcomes of rTMS/CIMT in pediatric stroke were investigated. Variability in performance and unattributed symptoms were noted. Considering the prevalence of co-occurring conditions in children and adolescents with stroke, new-onset symptoms were not attributed to original intervention. With the small sample size, the impact of rTMS on long-term outcomes cannot be fully determined from these data. Characterizing long-term outcomes through performance, participant perspectives, and medical status allows comprehensive assessment of rTMS/CIMT intervention efficacy.

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Childhood Mood Disorders: Major Depressive Disorder, Bipolar Disorder, and Disruptive Mood Dysregulation Disorder

Hulvershorn

Leibenluft

2015

Psychiatry

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Long-Term Follow-Up of Adolescents With Resistant Depression Treated With Repetitive Transcranial Magnetic Stimulation

Abstract: Preliminary evidence suggests that rTMS treatment of resistant depression in adolescents is not associated with long-term cognitive deterioration and that posttherapy clinical improvement can be maintained. It seems that some subjects may derive long-term benefit from the rTMS course.

Cited by 39 publications

References 5 publications

Treatment-Resistant Depression in Adolescents: A Comprehensive Review

Treatment-Resistant Depression in Adolescents: A Comprehensive Review

Repetitive Transcranial Magnetic Stimulation/Behavioral Intervention Clinical Trial: Long-Term Follow-Up of Outcomes in Congenital Hemiparesis

Childhood Mood Disorders: Major Depressive Disorder, Bipolar Disorder, and Disruptive Mood Dysregulation Disorder

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