Real-world retrospective study of repetitive transcranial magnetic stimulation (TMS) treatment for bipolar and unipolar depression using TMS registry data in Tokyo

Ikawa, H.; Osawa, R.; Takeda, Y.; Sato, A.; Mizuno, H.; Noda, Y.

Abstract:

Despite the prevalence of empirical practice, evidence supporting the use of repetitive transcranial magnetic stimulation (rTMS) in treating bipolar depression (BD) is sparse compared to that for unipolar depression. Therefore, this study aimed to conduct a retrospective observational analysis using TMS registry data to compare the efficacy of rTMS treatment for BD and unipolar depression. Data from 20 patients diagnosed with unipolar and BD were retrospectively extracted from the TMS registry to ensure age and sex matching. The primary outcomes of this registry study were measured using the 21-item Hamilton Depression Rating Scale (HAM-D21) and Montgomery−Åsberg Depression Rating Scale (MADRS). Analysis did not reveal significant differences between the two groups in terms of depression severity, motor threshold, or stimulus intensity at baseline. Similarly, no significant differences were observed in absolute or relative changes in the total HAM-D21 and MADRS scores. Furthermore, the response and remission rates following rTMS treatment did not differ significantly between groups. The only adverse event reported in this study was scalp pain at the stimulation site; however, the incidence and severity were not significantly different between the groups. In conclusion, this retrospective study, using real-world TMS registry data, suggests that rTMS treatment for BD could be as effective as that for unipolar depression. These findings underscore the need for further validation in prospective randomized controlled trials with larger sample sizes.

Patologie/Applicazioni:

• Depressione
• Stimolazione Magnetica Transcranica (TMS)

Anno:

2024

Tipo di pubblicazione:

Articolo

Testata scientifica:

Heliyon

Mese:

03

Nota:

Questo studio si pone l'obiettivo di analizzare se il trattamento rTMS contro il disturbo bipolare (BD) riscontri la stessa efficacia del trattamento rTMS contro la depressione unipolare. 20 pazienti affetti da BD e 20 pazienti affetti da depressione unipolar, provenienti da un background clinicodemografico comparabile, sono stati sottoposti a trattamenti rTMS noti in letteratura (rispettivamente LF-rTMS su DLPFC destra e iTBS su DLPFC sinistra) con uno stimolatore MagPro R30. Gli esiti dello studio dimostrano che non sono presenti differenze significative tra i gruppi nelle variazioni dei punteggi HAM-D 21 e MADRS tra pre e post trattamento. Inoltre, anche i tassi di risposta e di remissione dopo il trattamento non differiscono significativamente tra i gruppi. In conclusione, questo studio suggerisce che il trattamento LF-rTMS per il disturbo bipolare mostra lo stesso livello di efficacia del trattamento iTBS per la depressione unipolare.

DOI:

10.1016/j.heliyon.2024.e27288