Citation

Davila MC, Ely B, Manzardo AM. Ment. Illn. 2019; 11(1).

Copyright

(Copyright © 2019, PAGEPress Publications)

DOI

10.4081/mi.2019.7947

PMID

unavailable

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulatory technique used to modulate orbital frontal corticostriatal (OFC) activity and clinical symp-tomatology for psychiatric disorders involving OFC dysfunction. We examined the effectiveness of rTMS in the treatment of major depressive disorder in an applied clinical setting (Awakening KC CNI) to assess efficacy and optimize rTMS parameters within clinical practice. A retrospective review of medical records was carried out on patients with major depressive disorder undergoing rTMS therapy at Awakenings KC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) total score, clinical remission rate and week achieved were evaluated over 6 weeks of treatment to assess clinical response referencing two different rTMS instruments (MagVenture; NeuroStar). Our survey included 247 participants from males (N=98) and females (N=149) with average baseline PHQ-9 scores of 21.7±4, classified as severe depression. Clinically rated remission rates of 72% were achieved in 3.1±1.0 weeks and associated with prior history of psychiatric hospitalization, suicide attempts and substance use disorder. Average baseline PHQ-9 scores decreased significantly over time with proportionately greater remission rates achieved for patients treated using the MagVenture over NeuroStar instrument. rTMS in applied clinical practice is efficacious over a wide range of settings and patients. Clinical response was related to severity of depression symptoms (e.g., prior hospitalization; suicide attempts) validating efficacy in critically ill groups. Clinical response May be impacted by rTMS instrument, magnetic field parameters or individual factors. ©Copyright M.C. Davila et al., 2019 Licensee PAGEPress, Italy.

Language: en

Keywords

adult; human; Depression; female; male; aged; Treatment; sex difference; major depression; Transcranial magnetic stimulation; treatment outcome; repetitive transcranial magnetic stimulation; major clinical study; controlled study; clinical practice; retrospective study; health service; age distribution; ethnic difference; remission; Remission; treatment response; Article; clinical effectiveness; treatment duration; health care survey; very elderly; Patient Health Questionnaire 9; cognitive behavioral therapy; tertiary care center; RTMS; TMS