Age predicts low-frequency transcranial magnetic stimulation efficacy in major depression

Aguirre, Iratxe; Carretero, Blanca; Ibarra, Olga; Kuhalainen, Javier; Martínez, J. Larrauri; Ferrer, Alicia; Salvà, Joan; Roca, Miquel; Gili, Margalida; Montoya, Pedro; Garcı́a-Toro, Mauro

doi:10.1016/j.jad.2010.10.038

Cited by 45 publications

(39 citation statements)

References 18 publications

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“…Briefly, Stern et al (2007) reported that the rates of response and remission 2 weeks post-treatment increased from 10-33.3% (ie, from 1-3 subjects) and from 50-60% (ie, from 5-6 subjects) for the LF-rTMS group, respectively, and were maintained at 0% for the sham rTMS group. Also, Aguirre et al (2011) have shown that the rates of response and remission 4 weeks post-treatment increased from 33.3-38.9% (ie, from 6-7 subjects) and from 5.5-16.7% (ie, from 1-3 subjects) for the LF-rTMS group, respectively, and were maintained at the same initial level for the sham rTMS group. Encouragingly, a recent 6-month follow-up study with over 90 depressed subjects has shown that the therapeutic benefits of highfrequency rTMS are durable, and that it can be used for precluding impending relapse (Janicak et al, 2010).…”

Section: Limitationsmentioning

confidence: 87%

“…Also, we retrieved four RCTs on LF-rTMS for MD from MEDLINE, PsycINFO, EMBASE, CENTRAL, SCOPUS, and PQDT. Of these, only two RCTs met the eligibility criteria (Aguirre et al, 2011;Pallanti et al, 2010), as the remaining only applied LF-rTMS over the left DLPFC (Speer et al, 2009;Speer et al, 2000). Please refer to the Supplementary Material for a detailed description of the study selection procedure.…”

Section: Literature Searchmentioning

confidence: 99%

“…Fourth, we have only examined the efficacy of LF-rTMS at study end, and thus could not estimate the stability of its medium-to long-term antidepressant effects and/or its cost-effectiveness. This was mainly due to the absence of follow-up evaluations on all but two of the included RCTs (Aguirre et al, 2011;Stern et al, 2007). Briefly, Stern et al (2007) reported that the rates of response and remission 2 weeks post-treatment increased from 10-33.3% (ie, from 1-3 subjects) and from 50-60% (ie, from 5-6 subjects) for the LF-rTMS group, respectively, and were maintained at 0% for the sham rTMS group.…”

Section: Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Berlim

Eynde

Daskalakis

2012

Neuropsychopharmacol

248

141

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Clinical trials on low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) over the right dorsolateral prefrontal cortex have yielded conflicting evidence concerning its overall efficacy for treating major depression (MD). As this may have been the result of limited statistical power of individual trials, we have carried the present systematic review and meta-analysis to examine this issue. We searched the literature for English language randomized, double-blind and sham-controlled trials (RCTs) on LF-rTMS for treating MD from 1995 through July 2012 using EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, SCOPUS, and ProQuest Dissertations & Theses, and from October 2008 until July 2012 using MEDLINE. The main outcome measures were response and remission rates as well as overall dropout rates at study end. We used a random-effects model, odds ratios (ORs) and number needed to treat (NNT). Data were obtained from eight RCTs, totaling 263 subjects with MD. After an average of 12.6±3.9 rTMS sessions, 38.2% (50/131) and 15.1% (20/132) of subjects receiving active LF-rTMS and sham rTMS were classified as responders (OR ¼ 3.35; 95% CI ¼ 1.4-8.02; p ¼ 0.007). Also, 34.6% (35/101) and 9.7% (10/103) of subjects receiving active LF-rTMS and sham rTMS were classified as remitters (OR ¼ 4.76; 95% CI ¼ 2.13-10.64; po0.0001). The associated NNT for both response and remission rates was 5. Sensitivity analyses have shown that protocols delivering 41200 magnetic pulses in total as well as those offering rTMS as a monotherapy for MD were associated with higher rates of response to treatment. No differences on mean baseline depression scores and dropout rates for active and sham rTMS groups were found. Finally, the risk of publication bias was low. In conclusion, LF-rTMS is a promising treatment for MD, as it provides clinically meaningful benefits that are comparable to those of standard antidepressants and high-frequency rTMS. Furthermore, LF-rTMS seems to be an acceptable intervention for depressed subjects.

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Section: Limitationsmentioning

confidence: 87%

Section: Literature Searchmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Berlim

Eynde

Daskalakis

2012

Neuropsychopharmacol

248

141

View full text Add to dashboard Cite

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“…Studies including mixed-age samples (see Table 1 for details) have reported mixed results, with some showing an inverse relationship between age and antidepressant efficacy, whereas others have not reported an association. Studies reporting older age to be associated with lesser efficacy need, however, to be interpreted with caution [76,[78][79][80][81][82][83]. For example, two of these RCTs included a small number of participants in the older range (five women ≥ 55 years [76], nine patients ≥ 45 years [79]), which could have biased results.…”

Section: Repetitive Transcranial Magnetic Stimulation (Rtms) Rtms Effmentioning

confidence: 99%

“…Studies reporting older age to be associated with lesser efficacy need, however, to be interpreted with caution [76,[78][79][80][81][82][83]. For example, two of these RCTs included a small number of participants in the older range (five women ≥ 55 years [76], nine patients ≥ 45 years [79]), which could have biased results. A metaanalysis reported age (n=195, mean age: 51.1±15.1) years) as a negative predictor of rTMS efficacy [78], though the proportion of older patients represented in the sample is unclear and the six studies included administered rTMS at parameters that would currently be considered suboptimal (e.g., 10 sessions, 90-120 % of MT).…”

Section: Repetitive Transcranial Magnetic Stimulation (Rtms) Rtms Effmentioning

confidence: 99%

Neuromodulation Therapies for Geriatric Depression

Gálvez

Alonzo

et al. 2015

Curr Psychiatry Rep

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Depression is frequent in old age and its prognosis is poorer than in younger populations. The use of pharmacological treatments in geriatric depression is limited by specific pharmacodynamic age-related factors that can diminish tolerability and increase the risk of drug interactions. The possibility of modulating cerebral activity using brain stimulation techniques could result in treating geriatric depression more effectively while reducing systemic side effects and medication interactions. This may subsequently improve treatment adherence and overall prognosis in the older patient. Among clinically available neuromodulatory techniques, electroconvulsive therapy (ECT) remains the gold standard for the treatment of severe depression in the elderly. Studies have proven that ECT is more effective and has a faster onset of action than antidepressants in the treatment of severe, unipolar, geriatric depression and that older age is a predictor of rapid ECT response and remission. The application of novel and more tolerable forms of ECT for geriatric depression is currently being examined. Preliminary results suggest that right unilateral ultrabrief ECT (RUL-UB ECT) is a promising intervention, with similar efficacy to brief-pulse ECT and fewer adverse cognitive effects. Overall findings in repetitive transcranial magnetic stimulation (rTMS) suggest that it is a safe intervention in geriatric depression. Higher rTMS stimulation intensity and more treatments may need to be given in the elderly to achieve optimal results. There is no specific data on vagus nerve stimulation in the elderly. Transcranial direct current stimulation, magnetic seizure therapy and deep brain stimulation are currently experimental, and more data from geriatric samples is needed.

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Repetitive Transcranial Magnetic Stimulation for the Acute Treatment of Major Depressive Episodes

et al. 2017

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Age predicts low-frequency transcranial magnetic stimulation efficacy in major depression

Cited by 45 publications

References 18 publications

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Neuromodulation Therapies for Geriatric Depression

Repetitive Transcranial Magnetic Stimulation for the Acute Treatment of Major Depressive Episodes

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