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Updated: Sep 10, 2025

Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method
Published on: August 2, 2021
Personalised & optimised therapy (POT) algorithm using five cognitive and behavioural skills for subthreshold
Toshi A Furukawa1, Hisashi Noma2, Aran Tajika3
1Kyoto University Office of Institutional Advancement and Communications, Kyoto, Japan. furukawa@kuhp.kyoto-u.ac.jp.
Abstract:
Personalising psychotherapies for depression may enhance their efficacy. We conducted a randomised controlled trial of smartphone cognitive-behavioural therapy (CBT) among 4,469 adults in Japan (RESiLIENT trial, UMIN-CTR UMIN000047124). Participants received one of nine CBT skills or combinations, or a health information control (HI), over six weeks. All interventions were found efficacious. We developed prescriptive models using machine learning to forecast changes on the Patient Health Questionnaire-9 (PHQ-9) at week 26 and created a personalised and optimised therapy (POT) algorithm that recommended the most suitable CBT for each participant. In a simulated randomised comparison, the effect of POTs over HI was a difference by -1.41 (95%CI: -1.91 to -0.90) points on the PHQ-9 corresponding with a standardised mean difference of -0.37 (-0.49 to -0.23), which was 35% greater than that of the group-average best intervention. A new randomized trial to confirm the external validity and applicability of the algorithm is warranted.
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