Predictors of response and remission after transcranial magnetic stimulation for major depressive disorder: An international comparative study between Taiwan and Japan

• Published in: Asian journal of psychiatry Vol. 109; p. 104541
• Main Authors: Chu, Che-Sheng, Li, Cheng-Ta, Cheng, Chih-Ming, Jeng, Jia-Shyun, Pan, Chih-Chuan, Chen, Guan-Wei, Liang, Wei-Zhe, Chang, Chun-Hung, Fujii, Kyoshiro, Kitahata, Ryosuke, Noda, Yoshihiro
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2025
• Subjects: Adult; Depressive Disorder, Major - therapy; Female; Humans; International comparative study; Japan; Major depressive disorder; Male; Middle Aged; Outcome Assessment, Health Care - statistics & numerical data; Remission Induction; Retrospective Studies; Taiwan; Theta-burst stimulation; Transcranial magnetic stimulation; Transcranial Magnetic Stimulation - methods; Japan; Taiwan; International comparative study; Transcranial magnetic stimulation; Theta-burst stimulation; Major depressive disorder
• ISSN: 1876-2018; 1876-2026; 1876-2026
• DOI: 10.1016/j.ajp.2025.104541

This study aimed to identify demographic, clinical, and protocol-related predictors of effectiveness of transcranial magnetic stimulation (TMS) therapy in patients with major depressive disorder (MDD) across Taiwan and Japan. This retrospective observational study analyzed clinical data collected between September 2023 and August 2024 from patients with MDD treated either repetitive TMS or theta-burst stimulation at two institutes in Taiwan and one in Japan. All patients were assessed using the Hamilton Depression Rating Scale (HAMD) before and after a course of TMS treatment. Variables were assessed for their association with response, remission, and change of HAMD scores from baseline using a multiple logistic and linear regression model. 205 patients (131 Taiwanese and 74 Japanese) were included. The Taiwanese population had a significantly higher percentage of females than the Japanese population (71.0 % vs. 42.5 %). Being married (adjusted odd ratios [aOR] = 2.339) and being employed (aOR = 2.048) were more likely to achieve a response, whereas current alcohol use (aOR = 0.332) was less likely to be associated with response. Additionally, patients who were employed (aOR = 2.183) were more likely to achieve remission, whereas those with a longer duration of illness (aOR = 0.938) and current alcohol use (aOR = 0.310) were less likely to reach remission. Furthermore, being female, being married, being employed, and higher baseline HAMD were more likely having greater reductions in HAMD scores. This study suggests the specific predictors when predicting the treatment outcome of TMS for MDD patients in Taiwan and Japan. •The first comparative study for predictors of TMS efficacy across Taiwan and Japan.•To identify demographic, clinical, and protocol-related predictors.•Duration of illness, employment/marriage status, and alcohol use as potential predictors.