Sex differences in rTMS treatment response: A deep learning‐based EEG investigation

Abstract

Introduction The present study aimed to investigate sex differences in response to repetitive transcranial magnetic stimulation (rTMS) in Major Depressive Disorder (MDD) patients. Identifying the factors that mediate treatment response to rTMS in MDD patients can guide clinicians to administer more appropriate, reliable, and personalized interventions. Methods In this paper, we developed a novel pipeline based on convolutional LSTM‐based deep learning (DL) to classify 25 female and 25 male patients based on their rTMS treatment response. Results Five different classification models were generated, namely pre‐/post‐rTMS female (model 1), pre‐/post‐rTMS male (model 2), pre‐rTMS female responder versus pre‐rTMS female nonresponders (model 3), pre‐rTMS male responder vs. pre‐rTMS male nonresponder (model 4), and pre‐rTMS responder versus nonresponder of both sexes (model 5), achieving 93.3%, 98%, 95.2%, 99.2%, and 96.6% overall test accuracy, respectively. Conclusion These results indicate the potential of our approach to be used as a response predictor especially regarding sex‐specific antidepressant effects of rTMS in MDD patients.

Comprehensive review on sexual dimorphism to improve scalp acupuncture in nervous system disease

“…Furthermore, the research cited herein 45 showed that male brains responded significantly better to repetitive transcranial magnetic stimulation (rTMS) than female brains in patients with severe depression. Meanwhile, the sensitivity of the trigeminal nerve to pain is also different, 59 women are more susceptible to pain than men.…”

“…Male rats with an activated defecation center in the brain and spinal cord have an increased motility response to the colon, but it has no effect on the colon of female rats. Furthermore, the research cited herein 45 showed that male brains responded significantly better to repetitive transcranial magnetic stimulation (rTMS) than female brains in patients with severe depression. Meanwhile, the sensitivity of the trigeminal nerve to pain is also different, 59 women are more susceptible to pain than men.…”

“…Furthermore, 44 suggests that intestinal flora, intestinal and blood–brain barrier, and inflammatory responses may mediate the protective effect of prebiotics on anxiety‐like behavior in female mice. Furthermore, Andrew et al 45 proposed that sexually dimorphic estrogen perception in skeletal stem cells plays a controlling role in bone regeneration, and that skeletal stem cells (SSCS) of female mice are directly affected by estrogen signaling controls, which may improve bone fracture repair. J.M.…”

Home-based transcranial direct current stimulation (tDCS) in major depressive disorder: enhanced network synchronization with active relative to sham and deep learning-based predictors of remission

“…Measures of connectivity, asymmetry across hemispheres, and power in frontal and temporal electrodes are predictive of treatment response to antidepressant medication as well as to repetitive transcranial magnetic stimulation (rTMS) (Watts et al, 2022). Applying deep learning, treatment response to rTMS was predicted with accuracies over 90% (Adamson et al, 2022).…”

Decoding complexity

“…Alpha asymmetry in patients with MDD has been found to be associated with different antidepressant medications in a sex-specific manner, even after controlling for potential confounders such as sex and age (Arns et al 2016). Furthermore, a recent study employing a novel deep learning pipeline to classify patients' response to TMS found that TMS affects depression differently based on sex (Adamson et al 2022). Hence, it is plausible that factors associated with sex exert an influence on treatment outcomes.…”