Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, 87025 Limoges, France.
INSERM, U1094 Institut d'Epidémiologie et de Neurologie Tropicale, Université de Limoges, CHU Limoges, IRD U270, GEIST, 87000 Limoges, France.
Int J Environ Res Public Health. 2023 Mar 27;20(7):5276. doi: 10.3390/ijerph20075276.
Repetitive transcranial magnetic stimulation (rTMS) has been shown to be therapeutically effective for patients suffering from drug-resistant depression. The distinction between bipolar and unipolar disorders would be of great interests to better adapt their respective treatments. We aimed to identify the factors predicting clinical improvement at one month (M1) after the start of rTMS treatment for each diagnosis, which was preceded by a comparison of the patients' clinical conditions. We used the data collected and the method employed in a previous publication on 291 patients. Although the bipolar group had fewer responders, these patients seemed to better maintain their post-rTMS improvement on anxiety and perception of the severity of their illness than those in the unipolar group. For the bipolar group, young age coupled with low number of medications and high fatigue was shown to be the best combination for predicting improvement at M1. The duration of current depressive episode, which was previously demonstrated for whole group, combined with being attached was shown to favor clinical improvement among the patients in unipolar group. We were able to define a combination of specific factors related to each diagnosis for predicting the patients' clinical response. This could be extremely useful to predict the efficacy of rTMS during routine clinical practice in neuromodulation services.
重复经颅磁刺激（rTMS）已被证明对患有抗药性抑郁症的患者具有治疗效果。区分双相和单相障碍将极大地有助于更好地适应各自的治疗方法。我们旨在确定在 rTMS 治疗开始后一个月（M1）每个诊断的临床改善的预测因素，这是在比较患者的临床状况之前进行的。我们使用了之前在 291 名患者的研究中收集的数据和采用的方法。尽管双相组的应答者较少，但与单相组相比，这些患者在 rTMS 治疗后似乎更好地维持了他们在焦虑和对疾病严重程度的感知方面的改善。对于双相组，年轻的年龄加上较少的药物和较高的疲劳被证明是预测 M1 改善的最佳组合。先前针对整个组显示的当前抑郁发作持续时间与依恋相结合，有利于单相组患者的临床改善。我们能够为每个诊断定义一组与预测患者临床反应相关的特定因素的组合。这对于在神经调节服务的常规临床实践中预测 rTMS 的疗效可能非常有用。
