The following is a summary of “Depressive symptom dimensions predict the treatment effect of repetitive transcranial magnetic stimulation for post-stroke depression,” published in the August 2023 issue of the Psychosomatic Research by Qiu et al.

The non-invasiveness, minimal adverse effects, and treatment efficacy of repetitive transcranial magnetic stimulation (rTMS) have garnered considerable interest. Some patients with post-stroke depression (PSD) do not obtain complete symptom response or remission despite adequate duration of rTMS therapy. A prospective randomized controlled trial was conducted. Participants receiving rTMS were randomly assigned to one of three groups: ventromedial prefrontal cortex (VMPFC), left dorsolateral prefrontal cortex (DLPFC), or contralateral motor area (M1). 

Enrollment assessments and data collection were administered in weeks 0, 4, and 8. Using a linear mixed-effects model fitted with maximum likelihood, the influence of depressive symptom dimensions on treatment outcomes was examined. Univariate analysis of variance (ANOVA) and back-testing were used to determine the differences between the groups. There were a total of 276 patients included in the analysis. At 2, 4, and 8 weeks after treatment, the 17-item Hamilton Rating Scale for Depression (HAMD-17) scores of the DLPFC group were significantly different from those of the VMPFC and M1 groups (P<0.05). A more excellent observed mood score (β = -0.44, 95% CI: 0.85–0.04, P = 0.030) was associated with a more significant reduction in depressive symptoms in the DLPFC group. 

Higher neuro vegetative scores (β = 0.60, 95% CI: 0.25–0.96, P = 0.001) may indicate that the DLPFC group will experience less relief in depressive symptoms. Stimulation of the left DLPFC with high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) could substantially alleviate depressive symptoms in the subacute phase of subcortical ischemic stroke, and the severity of depressive symptoms at admission could predict the treatment effect.

Source: sciencedirect.com/science/article/abs/pii/S0022399923002398