TITLE
Impact of Prior Treatment on Remission with Intermittent Theta Burst Versus High-Frequency Repetitive Transcranial Magnetic Stimulation in Treatment Resistant Depression
SOURCE
Brain Stimulation. 12(6):1553-1555, 2019 Nov – Dec.
AUTHORS
Hsu JH; Downar J; Vila-Rodriguez F; Daskalakis ZJ; Blumberger DM.
ABSTRACT
Multiple prior treatment failures are associated with reduced rates of remission to subsequent antidepressant treatment, including rTMS. The degree of treatment resistance that is especially predictive of inferior outcome is uncertain. Intermittent theta burst stimulation (iTBS) is a newer form of rTMS where less is known regarding clinical predictors of remission. The THREE-D study demonstrated that iTBS is non-inferior to 10Hz rTMS for the treatment of depression.
OBJECTIVE
Determine if the number and type of prior pharmacotherapy trials affect the rate of remission with two types of rTMS.
METHODS
Compare remission rates based on prior pharmacotherapy using data from the THREE-D trial (NCT01887782).
RESULTS
No differences in remission rates were noted between the three levels of treatment resistance, however, participants with 3 compared to <3 treatment failures had lower rates of remission: 17.3% versus 29.4% (chi2 4.87; df=1; p=0.03).
CONCLUSIONS
Three or more treatment failures may be associated with lower remission rates with rTMS.
