TY - JOUR
T1 - Predictors of remission after repetitive transcranial magnetic stimulation for the treatment of late-life depression
AU - Göke, Katharina
AU - Trevizol, Alisson P.
AU - Ma, Clement
AU - Mah, Linda
AU - Rajji, Tarek K.
AU - Daskalakis, Zafiris J.
AU - Downar, Jonathan
AU - McClintock, Shawn M.
AU - Nestor, Sean M.
AU - Noda, Yoshihiro
AU - Mulsant, Benoit H.
AU - Blumberger, Daniel M.
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/4
Y1 - 2024/4
N2 - Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment in patients with depression, yet treatment response remains variable. While previous work has identified predictors of remission in younger adults, relatively little data exists in late-life depression (LLD). To address this gap, data from 164 participants with LLD from a randomized non-inferiority treatment trial comparing standard bilateral rTMS to bilateral theta burst stimulation (TBS) (ClinicalTrials.gov identifier: NCT02998580) were analyzed using binary logistic regression and conditional inference tree (CIT) modeling. Lower baseline depression symptom severity, fewer prior antidepressant treatment failures, and higher global cognition predicted remission following rTMS treatment. The CIT predicted a higher likelihood of achieving remission for patients with a total score of 19 or lower on the Montgomery-Åsberg Depression Rating Scale, 1 or fewer prior antidepressant treatment failures, and a total score of 23 or higher on the Montreal Cognitive Assessment. Our results indicate that older adults with lower severity of depression, fewer antidepressant treatment failures, and higher global cognition benefit more from current forms of rTMS. The results suggest that there is potentially higher value in using rTMS earlier in the treatment pathway for depression in older adults.
AB - Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment in patients with depression, yet treatment response remains variable. While previous work has identified predictors of remission in younger adults, relatively little data exists in late-life depression (LLD). To address this gap, data from 164 participants with LLD from a randomized non-inferiority treatment trial comparing standard bilateral rTMS to bilateral theta burst stimulation (TBS) (ClinicalTrials.gov identifier: NCT02998580) were analyzed using binary logistic regression and conditional inference tree (CIT) modeling. Lower baseline depression symptom severity, fewer prior antidepressant treatment failures, and higher global cognition predicted remission following rTMS treatment. The CIT predicted a higher likelihood of achieving remission for patients with a total score of 19 or lower on the Montgomery-Åsberg Depression Rating Scale, 1 or fewer prior antidepressant treatment failures, and a total score of 23 or higher on the Montreal Cognitive Assessment. Our results indicate that older adults with lower severity of depression, fewer antidepressant treatment failures, and higher global cognition benefit more from current forms of rTMS. The results suggest that there is potentially higher value in using rTMS earlier in the treatment pathway for depression in older adults.
KW - Brain stimulation
KW - Late-life depression
KW - Repetitive transcranial magnetic stimulation
KW - Treatment-resistant depression
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U2 - 10.1016/j.psychres.2024.115822
DO - 10.1016/j.psychres.2024.115822
M3 - Article
C2 - 38452496
AN - SCOPUS:85186728046
SN - 0165-1781
VL - 334
JO - Psychiatry research
JF - Psychiatry research
M1 - 115822
ER -