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Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation

BACKGROUND: Multiple factors likely impact response and remission rates in the treatment of depression with repetitive transcranial magnetic stimulation (rTMS). Notably, the role of symptom severity in outcomes with rTMS is poorly understood. OBJECTIVE/HYPOTHESIS: This study investigated the predict...

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Autores principales: Grammer, Geoffrey G., Kuhle, Andrew R., Clark, Caroline C., Dretsch, Michael N., Williams, Kathy A., Cole, Jeffrey T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554941/
https://www.ncbi.nlm.nih.gov/pubmed/26388786
http://dx.doi.org/10.3389/fpsyt.2015.00114
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author Grammer, Geoffrey G.
Kuhle, Andrew R.
Clark, Caroline C.
Dretsch, Michael N.
Williams, Kathy A.
Cole, Jeffrey T.
author_facet Grammer, Geoffrey G.
Kuhle, Andrew R.
Clark, Caroline C.
Dretsch, Michael N.
Williams, Kathy A.
Cole, Jeffrey T.
author_sort Grammer, Geoffrey G.
collection PubMed
description BACKGROUND: Multiple factors likely impact response and remission rates in the treatment of depression with repetitive transcranial magnetic stimulation (rTMS). Notably, the role of symptom severity in outcomes with rTMS is poorly understood. OBJECTIVE/HYPOTHESIS: This study investigated the predictors of achieving remission in patients suffering from depression who receive ≥3 rTMS treatments per week. METHODS: Available data on 41 patients treated at Walter Reed National Military Medical Center from 2009 to 2014 were included for analysis. Patients received a range of pulse sequences from 3,000 to 5,000 with left-sided or bilateral coil placement. Primary outcome measures were total score on the Patient Health Questionnaire-9 or the Quick Inventory of Depressive Symptomatology-Self Rated. Remission was defined as a total score less than five, and response was defined as a 50% decrease in the total score on both outcome metrics. Outcomes in patients diagnosed as suffering from mild or moderate depression were compared to those suffering from severe depression. RESULTS: Of the 41 patients receiving treatment, 16 reached remission and 18 reached response by the end of treatment. Remission rate was associated with the initial severity of depression, with patients with mild or moderate depression reaching remission at a significantly higher rate than those with severe depression. Total number of rTMS sessions or length of treatment was not predictors of remission. CONCLUSION: Patients with a baseline level of depression characterized as mild or moderate had significantly better outcomes following rTMS compared to patients with severe depression.
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spelling pubmed-45549412015-09-18 Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation Grammer, Geoffrey G. Kuhle, Andrew R. Clark, Caroline C. Dretsch, Michael N. Williams, Kathy A. Cole, Jeffrey T. Front Psychiatry Psychiatry BACKGROUND: Multiple factors likely impact response and remission rates in the treatment of depression with repetitive transcranial magnetic stimulation (rTMS). Notably, the role of symptom severity in outcomes with rTMS is poorly understood. OBJECTIVE/HYPOTHESIS: This study investigated the predictors of achieving remission in patients suffering from depression who receive ≥3 rTMS treatments per week. METHODS: Available data on 41 patients treated at Walter Reed National Military Medical Center from 2009 to 2014 were included for analysis. Patients received a range of pulse sequences from 3,000 to 5,000 with left-sided or bilateral coil placement. Primary outcome measures were total score on the Patient Health Questionnaire-9 or the Quick Inventory of Depressive Symptomatology-Self Rated. Remission was defined as a total score less than five, and response was defined as a 50% decrease in the total score on both outcome metrics. Outcomes in patients diagnosed as suffering from mild or moderate depression were compared to those suffering from severe depression. RESULTS: Of the 41 patients receiving treatment, 16 reached remission and 18 reached response by the end of treatment. Remission rate was associated with the initial severity of depression, with patients with mild or moderate depression reaching remission at a significantly higher rate than those with severe depression. Total number of rTMS sessions or length of treatment was not predictors of remission. CONCLUSION: Patients with a baseline level of depression characterized as mild or moderate had significantly better outcomes following rTMS compared to patients with severe depression. Frontiers Media S.A. 2015-09-01 /pmc/articles/PMC4554941/ /pubmed/26388786 http://dx.doi.org/10.3389/fpsyt.2015.00114 Text en Copyright © 2015 Grammer, Kuhle, Clark, Dretsch, Williams and Cole. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Grammer, Geoffrey G.
Kuhle, Andrew R.
Clark, Caroline C.
Dretsch, Michael N.
Williams, Kathy A.
Cole, Jeffrey T.
Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation
title Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation
title_full Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation
title_fullStr Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation
title_full_unstemmed Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation
title_short Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation
title_sort severity of depression predicts remission rates using transcranial magnetic stimulation
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554941/
https://www.ncbi.nlm.nih.gov/pubmed/26388786
http://dx.doi.org/10.3389/fpsyt.2015.00114
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