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

dc.contributor.author

Krepel, Noralie

dc.contributor.author

Rush, A John

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Iseger, Tabitha A

dc.contributor.author

Sack, Alexander T

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Arns, Martijn

dc.date.accessioned

2022-04-13T23:28:51Z

dc.date.available

2022-04-13T23:28:51Z

dc.date.issued

2020-01

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2022-04-13T23:28:51Z

dc.description.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.
dc.identifier

S0033291718004191

dc.identifier.issn

0033-2917

dc.identifier.issn

1469-8978

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

dc.language

eng

dc.publisher

Cambridge University Press (CUP)

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Psychological medicine

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10.1017/s0033291718004191

dc.subject

Prefrontal Cortex

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Humans

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Treatment Outcome

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Predictive Value of Tests

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ROC Curve

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Depressive Disorder, Major

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Personality Inventory

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Adult

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Middle Aged

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Female

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Male

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Transcranial Magnetic Stimulation

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Depressive Disorder, Treatment-Resistant

dc.title

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

dc.type

Journal article

duke.contributor.orcid

Rush, A John|0000-0003-2004-2382

pubs.begin-page

264

pubs.end-page

272

pubs.issue

2

pubs.organisational-group

Duke

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School of Medicine

pubs.publication-status

Published

pubs.volume

50

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