Cotovio Gonçalo, Boes Aaron D, Press Daniel Z, Oliveira-Maia Albino J, Pascual-Leone Alvaro
Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.
NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.
Front Aging Neurosci. 2022 Jul 19;14:919734. doi: 10.3389/fnagi.2022.919734. eCollection 2022.
Treatment resistant depression is common in older adults and treatment is often complicated by medical comorbidities and polypharmacy. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option for this group due to its favorable profile. However, early influential studies suggested that rTMS is less effective in older adults. This evidence remains controversial.
Here, we evaluated the rTMS treatment outcomes in a large international multicenter naturalistic cohort of >500 patients comparing older vs. younger adults.
We show that older adults, while having similar antidepressant response to younger adults, respond more slowly, which may help to explain differences from earlier studies when the duration of a treatment course was shorter.
Such evidence helps to resolve a long-standing controversy in treating older depressed patients with rTMS. Moreover, these findings provide an important data point in the call to revise policy decisions from major insurance providers that have unfairly excluded older adults.
难治性抑郁症在老年人中很常见，治疗常常因合并症和多种药物治疗而变得复杂。重复经颅磁刺激（rTMS）因其良好的特性，是该群体的一种治疗选择。然而，早期有影响力的研究表明，rTMS在老年人中效果较差。这一证据仍存在争议。
在此，我们在一个由500多名患者组成的大型国际多中心自然队列中评估了rTMS的治疗效果，比较了老年人和年轻人。
我们发现，老年人虽然与年轻人有相似的抗抑郁反应，但反应较慢，这可能有助于解释在治疗疗程较短时与早期研究结果不同的原因。
这些证据有助于解决在使用rTMS治疗老年抑郁症患者方面长期存在的争议。此外，这些发现为呼吁主要保险提供商修改不公平地将老年人排除在外的政策决定提供了一个重要的数据点。
