[Repetitive transcranial magnetic stimulation in major depression: response factor]

Area of Science:

• Neuroscience
• Psychiatry
• Medical Technology

Context:

• Repetitive transcranial magnetic stimulation (rTMS) is an emerging neuromodulation technique for psychiatric disorders.
• Major depression is a primary target for rTMS, with significant research into its efficacy.
• Predictors of antidepressive response to rTMS require updated synthesis.

Purpose:

• To review and synthesize current knowledge on positive predictors for antidepressive response to rTMS.
• To identify factors influencing rTMS effectiveness in major depression.
• To guide clinical application and future research directions.

Summary:

• A review of 29 studies identified key predictors for rTMS response in depression.
• Negative predictors include treatment resistance, long episode duration, advanced age, and psychotic symptoms.
• Positive predictors involve specific neuroimaging findings (e.g., inferior frontal activity) and stimulation parameters (e.g., intensity >100% motor threshold, >1000 stimulations/session, >10 treatment days).

Impact:

• Findings highlight the need to personalize rTMS parameters based on patient characteristics (e.g., age, cortical atrophy) and depression profile.
• Suggests potential for improved treatment outcomes by tailoring stimulation intensity, duration, and session number.
• Identifies areas for future research, including optimal stimulation protocols, maintenance treatment, and integration with neuroimaging data.