The impact of transcranial magnetic stimulation (TMS) on irritability occurring with acute major depressive disorder (MDD)

2020 ◽  
pp. 103985622094660
Author(s):  
Saxby Pridmore ◽  
Marzena Rybak ◽  
Renée Morey ◽  
Tamara May
Keyword(s):  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Naturalistic Study ◽  
Major Depressive ◽  
Dsm 5 ◽  
Clinical Global Impression Severity ◽  
The Impact

Objective: To examine the impact (if any) of a course of transcranial magnetic stimulation (TMS) on irritability occurring in association with acute major depressive disorder (MDD). Method: In a naturalistic study, patients with MDD according to DSM-5 criteria were given 20 daily TMS treatments. A visual analogue scale for irritability (VAS-I) was developed. Objective tools included the six-item Hamilton Depression Rating Scale (HAMDS6) and the Clinical Global Impression - Severity (CGI-S). Results: Fifty patients received 53 courses. Forty-seven courses achieved remission on both HAMD6 and CGI-S and six courses did not achieve remission with either. Irritability significantly reduced when MDD remission was achieved but was unchanged when remission was not achieved. Conclusion: TMS reduces irritability occurring in association with MDD when this treatment affects MDD remission, but not when remission is not affected.

The impact of ‘cluster maintenance TMS’ on irritability occurring in major depressive disorder

2020 ◽  
pp. 103985622094303 ◽  
Author(s):  
Saxby Pridmore ◽  
Yvonne Turnier-Shea ◽  
Sheila Erger ◽  
Tamara May
Keyword(s):  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Magnetic Stimulation ◽  
Subjective Measure ◽  
Naturalistic Study ◽  
Treatment Resistant ◽  
Major Depressive ◽  
The Impact ◽  
Cluster Maintenance

Objective: To determine the impact of clustered maintenance transcranial magnetic stimulation (TMS) on irritability occurring in treatment-resistant major depressive disorder (MDD). Method: A naturalistic study of 106 courses that includes pre- and posttreatment assessments of subjective and objective depression and a subjective measure of irritability developed for this study. Results: Forty-six participants (35 females), mean age 43.2 years (14.3), completed 106 courses. There was a significant reduction in irritability and depression scores ( p < .001). The change in irritability scores was significantly correlated with the change in depression scores, r = .40, p < .001. Conclusion: TMS has the capacity to reduce the irritability co-occurring with treatment-resistant MDD, known to be responsive to TMS. This increases the possibility of using TMS in the treatment of irritability co-occurring with other disorders or standing alone (should irritability be categorized as a stand-alone disorder).

scholarly journals Oxolipidomics profile in major depressive disorder: Comparing remitters and non-remitters to repetitive transcranial magnetic stimulation treatment

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246592
Author(s):  
Hannah Stirton ◽  
Benjamin P. Meek ◽  
Andrea L. Edel ◽  
Zahra Solati ◽  
Arun Surendran ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Major Depressive ◽  
Predict Treatment Response

Background Repetitive Transcranial Magnetic Stimulation [rTMS] is increasingly being used to treat Major Depressive Disorder [MDD]. Given that not all patients respond to rTMS, it would be clinically useful to have reliable biomarkers that predict treatment response. Oxidized phosphatidylcholine [OxPC] and some oxylipins are important plasma biomarkers of oxidative stress and inflammation. Not only is depression associated with oxidative stress, but rTMS has been shown to have anti-oxidative effects. Objectives To investigate whether plasma oxolipidomics profiles could predict treatment response in patients with treatment resistant MDD. Methods Fourty-eight patients undergoing rTMS treatment for MDD were recruited along with nine healthy control subjects. Plasma OxPCs and oxylipins were extracted and analyzed through high performance liquid chromatography coupled with mass spectrometry. Patients with a Hamilton Depression Rating Scale score [Ham-D] ≤7 post-treatment were defined as having entered remission. Results Fifty-seven OxPC and 32 oxylipin species were identified in our subjects. MDD patients who entered remission following rTMS had significantly higher pre-rTMS levels of total and fragmented OxPCs compared to non-remitters and controls [one-way ANOVA, p<0.05]. However, no significant changes in OxPC levels were found as a result of rTMS, regardless of treatment response [p>0.05]. No differences in plasma oxylipins were found between remitters and non-remitters at baseline. Conclusion Certain categories of OxPCs may be useful predictive biomarkers for response to rTMS treatment in MDD. Given that elevated oxidized lipids may indicate higher levels of oxidative stress and inflammation in the brain, patients with this phenotype of depression may be more receptive to rTMS treatment.

Change in Quantitative EEG Theta Cordance as a Potential Predictor of Repetitive Transcranial Magnetic Stimulation Clinical Outcome in Major Depressive Disorder

2017 ◽  
Vol 49 (5) ◽  
pp. 306-315 ◽  
Author(s):  
Aimee M. Hunter ◽  
Thien X. Nghiem ◽  
Ian A. Cook ◽  
David E. Krantz ◽  
Michael J. Minzenberg ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Clinical Outcome ◽  
Depressive Disorder ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Self Report ◽  
Major Depressive ◽  
Dry Electrode

Repetitive transcranial magnetic stimulation (rTMS) has demonstrated efficacy in major depressive disorder (MDD), although clinical outcome is variable. Change in the resting-state quantitative electroencephalogram (qEEG), particularly in theta cordance early in the course of treatment, has been linked to antidepressant medication outcomes but has not been examined extensively in clinical rTMS. This study examined change in theta cordance over the first week of clinical rTMS and sought to identify a biomarker that would predict outcome at the end of 6 weeks of treatment. Clinically stable outpatients (n = 18) received nonblinded rTMS treatment administered to the dorsolateral prefrontal cortex (DLPFC). Treatment parameters (site, intensity, number of pulses) were adjusted on an ongoing basis guided by changes in symptom severity rating scale scores. qEEGs were recorded at pretreatment baseline and after 1 week of left DLPFC (L-DLPFC) rTMS using a 21-channel dry-electrode headset. Analyses examined the association between week 1 regional changes in theta band (4-8 Hz) cordance, and week 6 patient- and physician-rated outcomes. Theta cordance change in the central brain region predicted percent change in Inventory of Depressive Symptomology–Self-Report (IDS-SR) score, and improvement versus nonimprovement on the Clinical Global Impression–Improvement Inventory (CGI-I) ( R2 = .38, P = .007; and Nagelkerke R2 = .78, P = .0001, respectively). The cordance biomarker remained significant when controlling for age, gender, and baseline severity. Treatment-emergent change in EEG theta cordance in the first week of rTMS may predict acute (6-week) treatment outcome in MDD. This oscillatory synchrony biomarker merits further study in independent samples.

scholarly journals Treatment for Major Depressive Disorder by Repetitive Transcranial Magnetic Stimulation in Different Parameters: A Randomized Double-Blinded Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Tingting Zhang ◽  
Yueqin Huang ◽  
Yi Jin ◽  
Xiaoyan Ma ◽  
Zhaorui Liu
Keyword(s):  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Repeated Measure ◽  
Major Depressive ◽  
Treatment Groups

Background: Repetitive transcranial magnetic stimulation (rTMS) has been proven to be safe and effective in treating major depressive disorder (MDD). However, the treatment parameters of rTMS are still divergent and need to be optimized further. The aim of this study was to compare the efficacy of rTMS in treating MDD with different parameters of stimulating frequency and location, and course of treatment.Methods: A total of 221 patients with MDD were recruited in the randomized, double-blind, controlled trial. All eligible patients were randomly assigned into four treatment groups: (1) 10 Hz in left dorsolateral pre-frontal cortex (DLPFC) (n = 55), (2) 5 Hz in left DLPFC (n = 53), (3) 10 Hz in bilateral DLPFC (n = 57), and (4) 5 Hz in bilateral DLPFC (n = 56). The patients received treatment for 6 weeks and an additional 6-week optional treatment. The efficacies were evaluated by Hamilton Depression Rating Scale-24 items (HDRS) and Clinical Global Impressions Scale (CGI). The trial is registered at the Chinese Clinical Trial Registry as ChiCTR-TRC-12002248.Results: The ANOVAs of HDRS scores up to 6 weeks and 12 weeks with repeated measure of time showed a significant effect of duration without statistical difference among four treatment groups and no significance when time was interacted with inter-group as well. The response rates up until the 5th week were significantly different with the previous week.Conclusions: It concludes that there were no statistical differences in the efficacy of rTMS between unilateral left and bilateral DLPFC, and between 5 and 10 Hz for treating MDD.

scholarly journals Comparison of clinical outcomes with two Transcranial Magnetic Stimulation treatment protocols for major depressive disorder

2021 ◽  
Vol 14 (1) ◽  
pp. 173-180
Author(s):  
LindaL. Carpenter ◽  
ScottT. Aaronson ◽  
Todd M. Hutton ◽  
Miriam Mina ◽  
Kenneth Pages ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Clinical Outcomes ◽  
Magnetic Stimulation ◽  
Major Depressive ◽  
Treatment Protocols

scholarly journals Impact of Repetitive Transcranial Magnetic Stimulation (rTMS) on Theory of Mind and Executive Function in Major Depressive Disorder and Its Correlation with Brain-Derived Neurotrophic Factor (BDNF): A Randomized, Double-Blind, Sham-Controlled Trial

2021 ◽  
Vol 11 (6) ◽  
pp. 765
Author(s):  
Jie Tong ◽  
Jie Zhang ◽  
Ying Jin ◽  
Weiqing Liu ◽  
Hao Wang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Executive Function ◽  
Transcranial Magnetic Stimulation ◽  
Theory Of Mind ◽  
Depressive Disorder ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Major Depressive ◽  
Double Blind ◽  
Perseverative Errors

Background: Studies have implicated hypofrontality in the pathogenesis of impaired theory of mind (ToM) and executive function (EF) in major depressive disorder (MDD). These symptoms are usually resistant to treatment. Repetitive transcranial magnetic stimulation (rTMS) has been shown to reverse hypofrontality. Moreover, BDNF is an effective biomarker of antidepressant effects, but there have been very few studies on the correlation between BDNF and rTMS. We aimed to evaluate the efficacy of 20 sessions of a 10 Hz unilateral rTMS intervention over the left dorsolateral prefrontal cortex (DLPFC) in improving ToM and EF in patients with MDD and its correlation with BDNF. Methods: A total of 120 MDD patients were enrolled in this randomized, sham-controlled, double-blind trial. Each participant received 20 sessions of rTMS at 10 Hz frequency through the active or the sham coil over 4 weeks. ToM was assessed with the facial emotion identification test (FEIT) and hinting task (HT). EF was assessed with the Wisconsin card sorting test (WCST). BDNF assessments were carried out at baseline and 2-, 4-, 12-, and 24-week follow-ups. Results: The improvement in the ToM (FEIT, HT) in the active rTMS group was significantly different from that in the sham rTMS group (F = 18.09, p < 0.001; F = 5.02, p = 0.026). There were significant differences in the WCST (categories completed, response errors, response perseverative errors, non-response perseverative errors) after logarithmic transformation at different time points in the active rTMS group (F = 14.71, p < 0.001; F = 5.99, p = 0.046; F = 8.90, p = 0.031; F = 2.31, p = 0.048). However, there was no significant difference in log transformed BDNF concentration between the two groups (t = 0.07 to t = 1.29, p > 0.05). BDNF was negatively correlated with WCST categories completed at the 24th week (r = −0.258, p = 0.046). Conclusions: The results show that rTMS may improve the ToM and EF of patients with MDD and there was no significant correlation with serum BDNF concentration. RTMS can not only be used for treatment of patients with MDD but also has a positive effect on ToM and EF.

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