Depressive symptom trajectories associated with standard and accelerated rTMS.

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Trials

Background:

• Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique used for treating depression.
• Previous research suggests distinct trajectories of depressive symptom response to rTMS.
• Accelerated rTMS protocols aim to deliver treatment more intensively.

Purpose of the Study:

• To investigate if an accelerated rTMS protocol leads to different depressive symptom response trajectories compared to a standard rTMS protocol.
• To validate previous findings on distinct depressive symptom response trajectories using an external dataset.

Main Methods:

• Analysis of data from two clinical trials comparing accelerated and standard rTMS protocols targeting the left dorsolateral prefrontal cortex (DLPFC).
• Inclusion of adult outpatients (18-70 years) with moderate-to-severe unipolar or bipolar depression who had inadequate response to antidepressants.
• Application of group-based trajectory modeling to identify MADRS response trajectories and regression techniques to assess the association between treatment protocol and trajectory.

Main Results:

• Four distinct depressive symptom response trajectories were identified: nonresponse (30.7%), minimal response (34.1%), higher symptoms, response (14.6%), and lower symptoms, response (20.6%).
• No significant association was found between the accelerated rTMS protocol and depressive symptom response trajectory, even after adjusting for baseline severity.

Conclusions:

• The accelerated rTMS protocol did not influence depressive symptom response trajectories in this study.
• This research provides further evidence supporting the existence of distinct depressive symptom response trajectories in patients receiving rTMS to the left DLPFC.