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

作者信息

Dumas R, Padovani R, Richieri R, Lançon C

机构信息

Pôle universitaire de psychiatrie, hôpital Sainte-Marguerite, Marseille cedex, France.

出版信息

Encephale. 2012 Sep;38(4):360-8. doi: 10.1016/j.encep.2011.08.004. Epub 2011 Oct 11.


DOI:10.1016/j.encep.2011.08.004
PMID:22980479
Abstract

OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) is a brain stimulation technique that has been investigated as a novel treatment for psychiatric disorders, notably in major depression, and has shown statistically significant effects. The authors found it necessary to propose an up-to-date review of positive predictors for antidepressive response to repetitive transcranial magnetic stimulation. METHOD: Based on an exhaustive consultation of Medline data, supplemented by a manual research, only works evaluating response factors of rTMS in major depression were retained. RESULTS: Twenty-nine studies were retained, including meta-analyses, reviews, randomized controlled trials and open trials. The most concordant data clearly indicate that a high score of treatment resistance, a long duration of current episode, advanced age, and psychotic symptoms are negative predictors for treatment response to rTMS. In the older patients, menopausal women are especially concerned. However, some parameters should be adapted to the degree of cortical atrophy such as intensity of stimulation or total number of rTMS sessions. Previous response to rTMS therapy seems to be a good predictor contrary to non-response to electroconvulsive therapy. Adjunctive antidepressant treatment shows greater responsiveness to rTMS contrary to benzodiazepine or anticonvulsant treatment. To our knowledge, no study compares unipolar and bipolar depression, the profile of depression is not established yet. Imaging studies show that TMS antidepressant responders differed from non-responders in inferior frontal activity, at baseline, and even more so following treatment. Furthermore, reduced baseline cerebral metabolism in cerebellar, temporal, anterior cingulate and occipital regions of the brain was correlated with improvement after two weeks of fast (20Hz) left dorsolateral prefrontal cortex (DLPFC) rTMS. Additionally, a right frontal region emerges with divergent polarity in the metabolic prediction of response to low rTMS. Inhibiting right DLPFC or stimulating DLPFC shows similar results, the choice on the side of stimulation does not seem determining. Bilateral stimulation for the moment does not seem superior to unilateral stimulation. Parameters of stimulation associated with effectiveness of rTMS are an intensity of stimulation higher than 100% of the motor threshold, a number of stimulations per sessions superior to 1000, and a full number of days of treatment greater than 10. DISCUSSION: Parameters of stimulation must be adapted according to the treated patients. For example, older patients who present cortical atrophy need higher intensity of stimulation. Other criteria could influence effectiveness of rTMS in the same way. Would it be necessary, for example, to adapt the duration or the intensity of stimulation according to the severity of the depressive episode or its duration of evolution? Do antecedents of resistance to a pharmacological treatment oblige us to stimulate differently? Few studies exceed 10 days of treatment; will longer duration of treatment be more effective? Also, we did not find any data on the interest of maintenance treatment among responders. Should the characteristics of the depressive disorder or its evolution require maintenance treatment? What will be its rhythm and its duration? Should we adapt rTMS parameters to abnormalities highlighted by functional neuroimagery? The prospects for work remain numerous.

摘要

相似文献

[1]
[Repetitive transcranial magnetic stimulation in major depression: response factor].

Encephale. 2012-9

[2]
Pre-treatment anterior cingulate activity as a predictor of antidepressant response to repetitive transcranial magnetic stimulation (rTMS).

Neuro Endocrinol Lett. 2007-10

[3]
[Affective disorders and repetitive transcranial magnetic stimulation: Therapeutic innovations].

Encephale. 2010-12

[4]
Patterns of response to repetitive transcranial magnetic stimulation (rTMS) in major depression: replication study in drug-free patients.

J Affect Disord. 2008-5

[5]
Metabolic alterations in the dorsolateral prefrontal cortex after treatment with high-frequency repetitive transcranial magnetic stimulation in patients with unipolar major depression.

J Psychiatr Res. 2007-10

[6]
[Therapeutic application of repetitive transcranial magnetic stimulation for major depression].

Seishin Shinkeigaku Zasshi. 2012

[7]
Shorter duration of depressive episode may predict response to repetitive transcranial magnetic stimulation.

Depress Anxiety. 2004

[8]
Positive predictors for antidepressive response to prefrontal repetitive transcranial magnetic stimulation (rTMS).

J Psychiatr Res. 2007-8

[9]
Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial.

Arch Gen Psychiatry. 2010-5

[10]
Antidepressant mechanism of add-on repetitive transcranial magnetic stimulation in medication-resistant depression using cerebral glucose metabolism.

J Affect Disord. 2010-7-3

引用本文的文献

[1]
The Scania Accelerated Intermittent Theta-burst Implementation Study (SATIS)-Lessons from an accelerated treatment protocol.

PLoS One. 2025-1-2

[2]
Predictors of response to accelerated rTMS in the treatment of treatment-resistant depression.

Eur Arch Psychiatry Clin Neurosci. 2024-9-18

[3]
Factors associated with antidepressant responses to repetitive transcranial magnetic stimulation in antidepressant-resistant depression.

Front Neurosci. 2022-12-2

[4]
Efficacy of transcranial magnetic stimulation in treatment-resistant depression.

Turk J Med Sci. 2022-8

[5]
Predictors of clinical response after rTMS treatment of patients suffering from drug-resistant depression.

Transl Psychiatry. 2021-11-15

[6]
A Systematic Review of Neuromodulation Treatment Effects on Suicidality.

Front Hum Neurosci. 2021-6-25

[7]
Predictors of Response to Repetitive Transcranial Magnetic Stimulation in Depression: A Review of Recent Updates.

Clin Psychopharmacol Neurosci. 2019-2-28

[8]
Mechanism of Repetitive Transcranial Magnetic Stimulation for Depression.

Shanghai Arch Psychiatry. 2018-4-25

[9]
Efficacy of intermittent Theta Burst Stimulation (iTBS) and 10-Hz high-frequency repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant unipolar depression: study protocol for a randomised controlled trial.

Trials. 2017-1-13

[10]
Use of the Temperament and Character Inventory to Predict Response to Repetitive Transcranial Magnetic Stimulation for Major Depression.

J Psychiatr Pract. 2016-5

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