Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; MRI-guided rTMS Clinic, Toronto Western Hospital, Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada.
Brain Stimul. 2019 Nov-Dec;12(6):1553-1555. doi: 10.1016/j.brs.2019.07.011. Epub 2019 Jul 17.
Multiple prior treatment failures are associated with reduced rates of remission to subsequent antidepressant treatment, including rTMS. The degree of treatment resistance that is especially predictive of inferior outcome is uncertain. Intermittent theta burst stimulation (iTBS) is a newer form of rTMS where less is known regarding clinical predictors of remission. The THREE-D study demonstrated that iTBS is non-inferior to 10 Hz rTMS for the treatment of depression.
Determine if the number and type of prior pharmacotherapy trials affect the rate of remission with two types of rTMS.
Compare remission rates based on prior pharmacotherapy using data from the THREE-D trial (NCT01887782).
No differences in remission rates were noted between the three levels of treatment resistance, however, participants with 3 compared to <3 treatment failures had lower rates of remission: 17.3% versus 29.4% (χ 4.87; df = 1; p = 0.03).
Three or more treatment failures may be associated with lower remission rates with rTMS.
多次先前的治疗失败与随后抗抑郁治疗（包括 rTMS）缓解率降低有关。对治疗抵抗的程度特别具有预测性的不良预后尚不确定。间歇性 theta 爆发刺激（iTBS）是一种较新的 rTMS 形式，关于其缓解的临床预测因素知之甚少。THREE-D 研究表明，iTBS 在治疗抑郁症方面与 10Hz rTMS 无差异。
确定先前的药物治疗试验的次数和类型是否会影响两种 rTMS 的缓解率。
使用来自 THREE-D 试验（NCT01887782）的数据，根据先前的药物治疗比较缓解率。
在三种治疗抵抗水平之间，缓解率没有差异，但是与<3 次治疗失败相比，有 3 次或更多治疗失败的患者缓解率较低：17.3%对 29.4%（χ 4.87；df=1；p=0.03）。
三次或更多次治疗失败可能与 rTMS 的缓解率降低有关。
