Fitzgerald Paul B, Hoy Kate E, Anderson Rodney J, Daskalakis Zafiris J
MonashAlfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, Victoria, Australia.
Temerty Centre for Therapeutic Brain Intervention and the Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Depress Anxiety. 2016 Aug;33(8):746-53. doi: 10.1002/da.22503. Epub 2016 Apr 5.
Considerable research has demonstrated the efficacy of repetitive transcranial magnetic stimulation (rTMS) treatment in patients with depression. However, limited research has described the pattern of response to rTMS treatment or explored possible predictors of the likelihood of treatment response.
Data from 11 clinical trials (n = 1,132) was pooled and we described the pattern of response to rTMS, rate of response, and remission as well as potential clinical and demographic predictors of response.
There was a bimodal pattern of response to rTMS with the response-associated peak at 57% reduction in depression rating scale scores. About 46% of patients achieved response criteria, with 31% completing rTMS treatment in remission. A greater likelihood of response was seen for patients who had less severe depression at baseline, a shorter duration of the current episode, and recurrent rather than single episode of depression. Greater response was also seen in patients treated at higher stimulation intensity.
A meaningful percentage (>40%) of patients respond to a course of rTMS treatment. Response does vary with a number of clinical and demographic variables but none of these variables exert a sufficiently strong influence on response rates to warrant using these criteria to exclude patients from treatment.
大量研究已证明重复经颅磁刺激（rTMS）治疗对抑郁症患者有效。然而，关于rTMS治疗反应模式的描述研究有限，且对治疗反应可能性的潜在预测因素探索不足。
汇总11项临床试验（n = 1132）的数据，我们描述了rTMS的反应模式、反应率和缓解情况以及反应的潜在临床和人口统计学预测因素。
rTMS的反应呈双峰模式，反应相关峰值出现在抑郁评定量表得分降低57%时。约46%的患者达到反应标准，31%在缓解状态下完成rTMS治疗。基线时抑郁程度较轻、当前发作持续时间较短以及为复发性而非单次发作抑郁症的患者，反应可能性更大。在较高刺激强度下接受治疗的患者反应也更明显。
相当比例（>40%）的患者对rTMS治疗疗程有反应。反应确实会因一些临床和人口统计学变量而有所不同，但这些变量均未对反应率产生足够强的影响，不足以依据这些标准将患者排除在治疗之外。
