Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation
Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation
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DOI：
10.1017/s1461145705006280
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发表时间：
2006-12-01
影响因子：
4.8
通讯作者：
Pascual-Leone, Alvaro
中科院分区：
文献类型：
--
作者：
Fregni, Felipe;Marcolin, Marco A.;Pascual-Leone, Alvaro
尽管先前的临床试验表明重复经颅磁刺激（rTMS）具有显著的抗抑郁作用，但这些试验的结果是异质的。我们假设个体患者的特征可能导致这种异质性。我们的目的是确定抗抑郁药对rTMS反应的预测因子。我们汇总了独立进行的六项独立临床试验的数据，这些试验评估了左侧背外侧前额叶皮质快速rTMS对重度抑郁症患者的影响。我们调查了195例患者的人口统计学，抑郁症和治疗特征，精神病和药物史。结果表明，当调整这些变量到其他显著的预测因素和混杂因素时，年龄和治疗难治性是抑郁改善的显著负预测因素。这些结果未受到6项研究的方法学差异的混淆，因为根据研究中心对结果进行了调整。总之，TMS抗抑郁治疗在年轻和治疗抵抗性较低的患者与更好的结果。
Although previous clinical trials have suggested that repetitive transcranial magnetic stimulation (rTMS) has a significant antidepressant effect, the results of these trials are heterogeneous. We hypothesized that individual patients' characteristics might contribute to such heterogeneity. Our aim was to identify predictors of antidepressant response to rTMS. We pooled data from six separate clinical trials conducted independently, which evaluated the effects of rapid rTMS of the left dorsolateral prefrontal cortex in patients with major depression. We investigated 195 patients with regard to demographic, depression and treatment characteristics, psychiatric and drug history. Results showed that age and treatment refractoriness were significant negative predictors of depression improvement when adjusting these variables to other significant predictors and confounders. These findings were not confounded by methodological differences from the six studies, as the results were adjusted for the study site. In conclusion TMS antidepressant therapy in younger and less treatment-resistant patients is associated with better outcome.