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

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2020-01

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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.

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Prefrontal Cortex, Humans, Treatment Outcome, Predictive Value of Tests, ROC Curve, Depressive Disorder, Major, Personality Inventory, Adult, Middle Aged, Female, Male, Transcranial Magnetic Stimulation, Depressive Disorder, Treatment-Resistant

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https://hdl.handle.net/10161/24805

Published Version (Please cite this version)

10.1017/s0033291718004191

Publication Info

Krepel, Noralie, A John Rush, Tabitha A Iseger, Alexander T Sack and Martijn Arns (2020). Can psychological features predict antidepressant response to rTMS? A Discovery-Replication approach. Psychological medicine, 50(2). pp. 264–272. 10.1017/s0033291718004191 Retrieved from https://hdl.handle.net/10161/24805.

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