Identification of clinical features and biomarkers that may inform a personalized approach to rTMS for depression

Abstract

Repetitive transcranial magnetic stimulation (rTMS), an established treatment for treatment-resistant depression, may hold promise as a personalized medicine approach for the treatment of major depressive disorder (MDD). Clinical research has begun to identify patient-specific factors that could be used to guide rTMS treatment decisions or individualized treatment approaches. This literature review describes a range of patient factors which have been evaluated as potential biomarkers of rTMS treatment response, including patient-and illnessrelated characteristics, genetic factors, and biomarkers derived from neuroimaging and EEG. We highlight the need for validation data for imaging and electrophysiological biomarkers associated with rTMS as well as prospective evaluation of clinical predictors. Finally, we consider implications for future efforts to move toward a personalized medicine approach in the treatment of depression with rTMS.

Heading for Personalized rTMS in Tinnitus: Reliability of Individualized Stimulation Protocols in Behavioral and Electrophysiological Responses

“…Individualization of magnetic stimulation might be capable of resolving the issue of effect variability within the same type of pathology. Its implementation in neuropsychiatric research is highly dependent on phenotypes as well as the identification of appropriate and valid clinical or physiological outcome measures [39,40]. However, tinnitus provides the tremendous benefit of direct reactions from the patients' side by virtue of changes in tinnitus perception and can therefore function as a kind of role model in rTMS personalization.…”

Can early treatment response serve as a predictor of antidepressant outcome of repetitive Transcranial Magnetic Stimulation?

“…Clinically relevant markers to predict therapeutic response to Transcranial Magnetic Stimulation (TMS) for Major Depressive Disorder would curtail potentially futile burden on available resources and aid in redirecting or modifying treatment course. To this end, biomarkers such as magnetic resonance imaging and electroencephalography have been studied with some promising results but currently not at a clinically translatable state [1].…”

Heading for personalized rTMS in tinnitus: reliability of individualized stimulation protocols in behavioral and electrophysiological responses

“…Individualization of magnetic stimulation might be capable of resolving the issue of effect variability within the same type of pathology. Its implementation in neuropsychiatric research is highly dependent on phenotypes as well as the identification of appropriate and valid clinical or physiological outcome measures (Cocchi & Zalesky, 2018; Garnaat et al, 2019). However, tinnitus provides the tremendous benefit of direct reactions from the patients’ side by virtue of changes in tinnitus perception and can therefore function as a kind of role model in rTMS personalization.…”