Clinical and demographic predictors of response to rTMS treatment in unipolar and bipolar depressive disorders

Publication date: Available online 24 July 2017
Source:Clinical Neurophysiology
Author(s): Reza Rostami, Reza Kazemi, Michael A. Nitsche, Fatemeh Gholipour, Mohammad Ali Salehinejad
ObjectivePrevious studies investigated predictors of transcranial magnetic stimulation (rTMS) response in depressive disorders but there is still limited knowledge especially about clinical predictors. Moreover, predictors of rTMS response in bipolar depression is less studied than unipolar depression.MethodsWe performed a logistic regression analysis in 248 patients with depressive disorders (unipolar N = 102, bipolar N = 146) who received 20 sessions of dLPFC rTMS (High-frequency rTMS, low-frequency rTMS, bilateral rTMS) to investigate significant demographic and clinical predictors for rTMS response. We also investigated effects of depression type, response (yes, no) and time on reducing somatic and cognitive-affective symptoms of patients.ResultsDepression type (unipolar vs. bipolar) did not have a significant effect on rTMS response. 45% of all patients, 51.5% of UDD patients and 41% of BDD patients, responded to rTMS treatment. Age was the only significant demographic predictor of treatment response in all patients. Cognitive-affective symptoms, compared to somatic symptoms were significant predictors for treatment response to rTMS. A series of common and unique clinical predictor for UDD and BDD were identified.ConclusionsYounger patients and those with more cognitive-affective rather than somatic symptoms benefit more from dLPFC rTMS treatment.SignificancerTMS is effective in both UDD and BDD but clinicians are encouraged target patients that benefit most from rTMS treatment based on their clinical and demographic profile.



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