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A naturalistic, multi-site study of repetitive transcranial magnetic stimulation therapy for depression.

Publication ,  Journal Article
Taylor, SF; Bhati, MT; Dubin, MJ; Hawkins, JM; Lisanby, SH; Morales, O; Reti, IM; Sampson, S; Short, EB; Spino, C; Watcharotone, K; Wright, J
Published in: J Affect Disord
January 15, 2017

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) was approved in 2008 in the United States, and there are relatively few studies describing its use in regular clinical practice since approval. METHODS: From April 2011 to October 2014, ten sites within the National Network of Depression Centers (NNDC) provided data on 62 evaluable patients with a depressive episode. Treatment was determined naturalistically. Response was assessed by the Quick Inventory of Depressive Symptoms, Self-Report (QIDS-SR) as the primary outcome, and the Patient Health Questionnaire-9 (PHQ-9) and the clinician-rated Clinical Global Impression (CGI) as secondary depression measures. RESULTS: Enrolled patients exhibited significant treatment resistance, with 70.2% reporting more than 4 prior depressive episodes. Most patients received treatment with standard parameters (10Hz over the left dorsolateral prefrontal cortex), although 22.6% of the patients received 1 or 5Hz stimulation at some point. Over 6 weeks of treatment, response and remission rates were 29.4% and 5.9%, respectively, for the QIDS-SR; 39.2% and 15.7%, respectively, for the PHQ-9; and 50.9% and 17.9%, respectively, for the CGI. Moderator analyses revealed no effect of prior depressive episodes, history of ECT or gender, although early life stress predicted a better response to rTMS therapy. LIMITATIONS: The study was an open-label, registry trial, with relatively coarse clinical data, reflecting practice only in academic, depression-specialty centers. Because of the relatively small size and heterogeneity of the sample, type 2 errors are possible and positive findings are in need of replication. CONCLUSION: rTMS demonstrates effectiveness in clinical practice within the NNDC, although remission rates appear slightly lower in comparison with other recent naturalistic studies.

Duke Scholars

Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

January 15, 2017

Volume

208

Start / End Page

284 / 290

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Transcranial Magnetic Stimulation
  • Self Report
  • Remission Induction
  • Regression Analysis
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Middle Aged
  • Male
  • Humans
 

Citation

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MLA
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Taylor, S. F., Bhati, M. T., Dubin, M. J., Hawkins, J. M., Lisanby, S. H., Morales, O., … Wright, J. (2017). A naturalistic, multi-site study of repetitive transcranial magnetic stimulation therapy for depression. J Affect Disord, 208, 284–290. https://doi.org/10.1016/j.jad.2016.08.049
Journal cover image

Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

January 15, 2017

Volume

208

Start / End Page

284 / 290

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Transcranial Magnetic Stimulation
  • Self Report
  • Remission Induction
  • Regression Analysis
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Middle Aged
  • Male
  • Humans