Clinical Predictors of Response to rTMS in Patients with Depressive Disorder

Document Type : Research Paper


Department of Health Psychology, faculty of psychology and Educational Science, University of Tehran


Repetitive Transcranial Magnetic Stimulation (rTMS) on prefrontal cortex is a new approach in patients diagnosed with depression. rTMS treatment response is different on different patients. Identifying response predictors plays a key role in treating patients with depression using rTMS. This research has aimed to study the demographic and clinical predictors of response to rTMS in patients with depression. This is a natural retrospective study on 248 patients with depression. The patients underwent rTMS treatment in Atieh Clinical Neurosciences Center, Tehran, Iran from May 2012 to December 2014 in order to treat their depression. Three common rTMS protocols were employed for the treatment: High-Frequency Stimulation, Low-Frequency Stimulation, and Bilateral Stimulation of the dorsolateral prefrontal cortex. All patients received rTMS three days a week for one month. Response to treatment was defined by the Beck Depression Inventory (BDI-II) and 50% reduction of scores compared to the baseline. Data were analyzed using logistic regression. Out of 248 patients, 110 (44%) responded to rTMS. Out of 98 patients with unipolar depression, 50 (51%) responded to rTMS. Similarly, out of 142 patients with bipolar depression, 60 (42%) responded to the treatment. Age, pessimism, sense of failure, agitation, loss of interest, indecisiveness, irritability, and somatic preoccupation were predictor variables of response to treatment in all patients. Among unipolar depressive patients, loss of interest, and somatic preoccupation, loss of energy and worthlessness were found to be the predictor variables, while sadness, feelings of failure, self-criticalness, irritability, loss of interest, change in sleep patterns, and somatic preoccupation were found to be the predictor variables of response to treatment in bipolar depressive patients. Age and clinical predictor variables can be used to predict the response to rTMS treatment.


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