rTMS for pharmacoresistant major depression in the clinical setting of a psychiatric hospital: Effectiveness and effects of age

Ciobanu, Cristina; Girard, M.; Marin, Benoît; Labrunie, Anaïs; Malauzat, D.

doi:10.1016/j.jad.2013.03.024

Cited by 26 publications

(13 citation statements)

References 39 publications

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“…There were no differences found in recovery rates between males and females, or age. While there has been previous research that showed younger patients responded better to rTMS (Pallanti et al, 2012), a number of studies have been unable to show any difference in rtMS response between both age and gender (Conca et al, 2000;Ciobanu et al, 2013;Rosenich et al, 2018).…”

Section: Discussionmentioning

confidence: 98%

Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice

Griffiths

Silva

Vai

et al. 2019

OJD

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Objective: The aim of this paper is to present the service data results from a clinical repetitive Transcranial Magnetic Stimulation (rTMS) service treating treatment resistant depression (TRD). Methods: The study was a retrospective investigation of routinely collected data on patients receiving rTMS between 2015 and 2018. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Physical Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7). The outcome data of 144 patients with TRD was analysed. The sample included patients with co-morbid psychiatric diagnosis. Results: Response and remission rates respectively were 34.6% and 20.6% for the HAM-D; 10% and 28.6% for the PHQ-9; 31% and 31.8% for the CGI; and 24.6% and 28.8% for GAD-7. Effect sizes were mostly medium (0.48, 0.27, 0.51, 0.43 respectively). GAD-7 reliable change improvement was 56.1% and PHQ-9 reliable change improvement was 40%. There was a medium positive correlation between anxiety (GAD-7) and depression recovery (HAM-D), r = 0.31, n = 46, p = 0.039, with lower pre-treatment anxiety associated with lower post-treatment HAM-D scores. Conclusions: TRD patients with low pre-treatment anxiety levels respond to treatment better than those with high pre-treatment anxiety. The results show that a clinical rTMS service can have a significant impact on symptoms of depression and anxiety in TRD. The findings support wider availability of rTMS as a treatment option for people with TRD.

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Section: Discussionmentioning

confidence: 98%

Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice

Griffiths

Silva

Vai

et al. 2019

OJD

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“…Pharmacological approaches actually rely on: posology optimization; switch (if inefficiency or intolerance); antidepressant association or potentiation with non-antidepressant treatments; and more or less adjuvant symptomatologic treatments [36,58]. In addition to these strategies, rTMS may have the potential to improve treatment-resistant unipolar depression [59], with the advantages of being painless, well-tolerated, and twice as effective as placebo [60], even among elderly persons [61]. In a meta-analysis about rTMS efficacy, Kedzior et al [51] demonstrated a significant decrease of depression scores 16 months after rTMS sessions, with an initial gain over 3 months after the last rTMS cure session.…”

Section: Discussionmentioning

confidence: 99%

Cost-utility analysis of curative and maintenance repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant unipolar depression: a randomized controlled trial protocol

Bulteau

Laurin

Volteau

et al. 2020

Trials

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Background: Depression is a debilitating and costly disease for our society, especially in the case of treatmentresistant depression (TRD). Repetitive transcranial magnetic stimulation (rTMS) is an effective adjuvant therapy in treatment-resistant unipolar and non-psychotic depression. It can be applied according to two therapeutic strategies after an initial rTMS cure: a further rTMS cure can be performed at the first sign of relapse or recurrence, or systematic maintenance rTMS (M-rTMS) can be proposed. TMS adjuvant to treatment as usual (TAU) could improve long-term prognosis. However, no controlled study has yet compared the cost-effectiveness of these two additional rTMS therapeutic strategies versus TAU alone. Methods/design: This paper focuses on the design of a health-economic, prospective, randomized, double-blind, multicenter study with three parallel arms carried out in France. This study assesses the cost-effectiveness of the adjunctive and maintenance low frequency rTMS on the right dorsolateral prefrontal cortex versus TAU alone. A total of 318 patients suffering from a current TRD will be enrolled. The primary endpoint is to investigate the incremental cost-effectiveness ratio (ICER) (ratio costs / quality-adjusted life-years [QALY] measured by the Euroqol Five Dimension Questionnaire) over 12 months in a population of patients assigned to one of three arms: systematic M-rTMS for responders (arm A); additional new rTMS cure in case of mood deterioration among responders (arm B); and a placebo arm (arm C) in which responders are allocated in two subgroups: sham systematic M-rTMS and supplementary rTMS course in case of mood deterioration. ICER and QALYs will be compared between arm A or B versus arm C. The secondary endpoints in each three arms will be: ICER at 24 months; the cost-utility ratio analysis at 12 and 24 months; 5-year budget impact analysis; and prognosis factors of

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“…Patient age has been of much interest within the rTMS treatment literature and investigations into the relationship between age and rTMS efficacy have largely produced mixed results. A number of rTMS studies have found support for the notion that rTMS may be less effective for depression in older individuals (e.g., [5,[14][15][16]), while others have not found age to be a significant predictor of rTMS outcomes (e.g., [6,7,17,18]). At least one group has found the relationship between age and rTMS outcome to be curvilinear [19].…”

Section: Demographic and Clinical Characteristicsmentioning

confidence: 99%

Identification of clinical features and biomarkers that may inform a personalized approach to rTMS for depression

Garnaat

Fukuda

Yuan

et al. 2019

Personalized Medicine in Psychiatry

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Repetitive transcranial magnetic stimulation (rTMS), an established treatment for treatment-resistant depression, may hold promise as a personalized medicine approach for the treatment of major depressive disorder (MDD). Clinical research has begun to identify patient-specific factors that could be used to guide rTMS treatment decisions or individualized treatment approaches. This literature review describes a range of patient factors which have been evaluated as potential biomarkers of rTMS treatment response, including patient-and illnessrelated characteristics, genetic factors, and biomarkers derived from neuroimaging and EEG. We highlight the need for validation data for imaging and electrophysiological biomarkers associated with rTMS as well as prospective evaluation of clinical predictors. Finally, we consider implications for future efforts to move toward a personalized medicine approach in the treatment of depression with rTMS.

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rTMS for pharmacoresistant major depression in the clinical setting of a psychiatric hospital: Effectiveness and effects of age

Cited by 26 publications

References 39 publications

Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice

Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice

Cost-utility analysis of curative and maintenance repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant unipolar depression: a randomized controlled trial protocol

Identification of clinical features and biomarkers that may inform a personalized approach to rTMS for depression

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