Can psychological features predict antidepressant response to rTMS? A Discovery-Replication approach

Noralie Krepel, A. John Rush, Tabitha A. Iseger, Alexander T. Sack, Martijn Arns*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Few studies focused on the relationship between psychological measures, major depressive disorder (MDD) and repetitive transcranial magnetic stimulation (rTMS) response. This study investigated several psychological measures as potential predictors for rTMS treatment response. Additionally, this study employed two approaches to evaluate the robustness of our findings by implementing immediate replication and full-sample exploration with strict p-thresholding.

METHODS: This study is an open-label, multi-site study with a total of 196 MDD patients. The sample was subdivided in a Discovery (60% of total sample, n = 119) and Replication sample (40% of total sample, n = 77). Patients were treated with right low frequency (1 Hz) or left high frequency (10 Hz) rTMS at the dorsolateral prefrontal cortex. Clinical variables [Beck Depression Inventory (BDI), Neuroticism, Extraversion, Openness Five-Factor Inventory, and Depression, Anxiety, and Stress Scale, and BDI subscales] were obtained at baseline, post-treatment, and at follow-up. Predictors were analyzed in terms of statistical association, robustness (independent replication), as well as for their clinical relevance [positive predictive value (PPV) and negative predictive value (NPV)].

RESULTS: Univariate analyses revealed that non-responders had higher baseline anhedonia scores. Anhedonia scores at baseline correlated negatively with total BDI percentage change over time. This finding was replicated. However, anhedonia scores showed to be marginally predictive of rTMS response, and neither PPV nor NPV reached the levels of clinical relevance.

CONCLUSIONS: This study suggests that non-responders to rTMS treatment have higher baseline anhedonia scores. However, anhedonia was only marginally predictive of rTMS response. Since all other psychological measures did not show predictive value, it is concluded that psychological measures cannot be used as clinically relevant predictors to rTMS response in MDD.

Original languageEnglish
Article number0033291718004191
Pages (from-to)264-272
Number of pages9
JournalPsychological Medicine
Volume50
Issue number2
Early online date24 Jan 2019
DOIs
Publication statusPublished - Jan 2020

Keywords

  • ANHEDONIA
  • ANXIETY
  • ANXIOUS DEPRESSION
  • DOUBLE-BLIND
  • MAJOR DEPRESSIVE DISORDER
  • Major depressive disorder
  • PERSONALITY-TRAITS
  • STAR-ASTERISK-D
  • TRANSCRANIAL MAGNETIC STIMULATION
  • TREATMENT OUTCOMES
  • TREATMENT-RESISTANT DEPRESSION
  • psychological measures
  • rTMS
  • treatment prediction

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