Cognitive and volumetric predictors of response to repetitive transcranial magnetic stimulation (rTMS) — A prospective follow-up study

• Published in: Psychiatry research. Neuroimaging Vol. 202; no. 1; pp. 12 - 19
• Main Authors: Furtado, Christina P, Hoy, Kate E, Maller, Jerome J, Savage, Greg, Daskalakis, Zafiris J, Fitzgerald, Paul B
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 30.04.2012; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Amygdala; Automated segmentation; Biological and medical sciences; Brain - pathology; Cognition; Cognition - physiology; Cognitive ability; Cognitive function; Cortex (entorhinal); Cortex (temporal); Depression; Depressive Disorder, Treatment-Resistant - pathology; Depressive Disorder, Treatment-Resistant - psychology; Depressive Disorder, Treatment-Resistant - therapy; Female; Follow-Up Studies; Hippocampus; Humans; Imaging; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Mood disorders; Neuroimaging; Neuropsychological Tests; Organ Size; Predictive Value of Tests; Prospective Studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Radiology; Temporal lobe; Transcranial magnetic stimulation; Transcranial Magnetic Stimulation - methods; Treatment Outcome; Treatment resistant depression; Volumetric analysis; Volumetric analysis; Treatment resistant depression; Cognitive function; Imaging; Automated segmentation; Mood disorder; Human; Treatment resistance; Transcranial magnetic stimulation; Segmentation; Image processing; Central nervous system; Depression; Cognition; Encephalon; Follow up study; Predictive factor
• ISSN: 0925-4927; 1872-7506
• DOI: 10.1016/j.pscychresns.2012.02.004

Abstract As the prevalence of treatment resistant depression (TRD) continues to rise, it remains a clinically important issue to identify neurobiological-, patient- and treatment-related factors that could potentially predict response to treatment. Medial temporal lobe (MTL) structures, in particular the hippocampus and amygdala have been implicated in inferior treatment response. The role of related structures such as the entorhinal cortex and the impact of MTL abnormalities on neurocognitive function, however, have not been systematically examined. The current study investigated MTL abnormalities and neurocognitive characteristics of eventual treatment responders and non-responders to a course of repetitive transcranial magnetic stimulation (rTMS) in order to identify potential predictors of treatment outcome. Prior to rTMS treatment all patients underwent magnetic resonance imaging (MRI) and neuropsychological assessment. MRI analysis was conducted using FreeSurfer 5.0. There was a 50% response rate following up to a 6-week course of daily rTMS treatments. Treatment response was defined as 50% reduction in Hamilton Depression Rating Scale and BDI-II scores from baseline. There was no difference in pre-treatment neurocognitive profiles and MTL volumes between eventual treatment responders and non-responders. Smaller pre-treatment left hippocampus volume showed a trend towards predicting eventual subjective improvement in depressive symptomatology. Although preliminary, our findings suggest that structural abnormalities may have some potential for predicting outcome to rTMS.