PURPOSE: The aim of this study was to determine the predictive value of whole-brain voxel-based regional cerebral blood flow (rCBF) for repetitive transcranial magnetic stimulation (rTMS) response in patients with pharmacoresistant depression. METHODS: Thirty-three right-handed patients who met DSM-IV criteria for major depressive disorder (unipolar or bipolar depression) were included before rTMS. rTMS response was defined as at least 50% reduction in the baseline Beck Depression Inventory scores. The predictive value of (99m)Tc-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) for rTMS response was studied before treatment by comparing rTMS responders to non-responders at voxel level using Statistical Parametric Mapping (SPM) (p < 0.001, uncorrected). RESULTS: Of the patients, 18 (54.5%) were responders to rTMS and 15 were non-responders (45.5%). There were no statistically significant differences in demographic and clinical characteristics (p > 0.10). In comparison to responders, non-responders showed significant hypoperfusions (p < 0.001, uncorrected) in the left medial and bilateral superior frontal cortices (BA10), the left uncus/parahippocampal cortex (BA20/BA35) and the right thalamus. The area under the curve for the combination of SPECT clusters to predict rTMS response was 0.89 (p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the combination of clusters were: 94, 73, 81 and 92%, respectively. CONCLUSION: This study shows that, in pharmacoresistant depression, pretreatment rCBF of specific brain regions is a strong predictor for response to rTMS in patients with homogeneous demographic/clinical features.
PURPOSE: The aim of this study was to determine the predictive value of whole-brain voxel-based regional cerebral blood flow (rCBF) for repetitive transcranial magnetic stimulation (rTMS) response in patients with pharmacoresistant depression. METHODS: Thirty-three right-handed patients who met DSM-IV criteria for major depressive disorder (unipolar or bipolar depression) were included before rTMS. rTMS response was defined as at least 50% reduction in the baseline Beck Depression Inventory scores. The predictive value of (99m)Tc-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) for rTMS response was studied before treatment by comparing rTMS responders to non-responders at voxel level using Statistical Parametric Mapping (SPM) (p < 0.001, uncorrected). RESULTS: Of the patients, 18 (54.5%) were responders to rTMS and 15 were non-responders (45.5%). There were no statistically significant differences in demographic and clinical characteristics (p > 0.10). In comparison to responders, non-responders showed significant hypoperfusions (p < 0.001, uncorrected) in the left medial and bilateral superior frontal cortices (BA10), the left uncus/parahippocampal cortex (BA20/BA35) and the right thalamus. The area under the curve for the combination of SPECT clusters to predict rTMS response was 0.89 (p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the combination of clusters were: 94, 73, 81 and 92%, respectively. CONCLUSION: This study shows that, in pharmacoresistant depression, pretreatment rCBF of specific brain regions is a strong predictor for response to rTMS in patients with homogeneous demographic/clinical features.
Authors: T A Kimbrell; J T Little; R T Dunn; M A Frye; B D Greenberg; E M Wassermann; J D Repella; A L Danielson; M W Willis; B E Benson; A M Speer; E Osuch; M S George; R M Post Journal: Biol Psychiatry Date: 1999-12-15 Impact factor: 13.382
Authors: J L Martinot; P Hardy; A Feline; J D Huret; B Mazoyer; D Attar-Levy; S Pappata; A Syrota Journal: Am J Psychiatry Date: 1990-10 Impact factor: 18.112
Authors: Paul E Holtzheimer; William M McDonald; Mustafa Mufti; Mary E Kelley; Sinéad Quinn; German Corso; Charles M Epstein Journal: Depress Anxiety Date: 2010-10 Impact factor: 6.505
Authors: Felix M Mottaghy; Christian E Keller; Massimo Gangitano; Jennifer Ly; Mark Thall; J Anthony Parker; Alvaro Pascual-Leone Journal: Psychiatry Res Date: 2002-08-20 Impact factor: 3.222
Authors: D A Seminowicz; H S Mayberg; A R McIntosh; K Goldapple; S Kennedy; Z Segal; S Rafi-Tari Journal: Neuroimage Date: 2004-05 Impact factor: 6.556
Authors: Jennifer Barredo; John A Bellone; Melissa Edwards; Linda L Carpenter; Stephen Correia; Noah S Philip Journal: Depress Anxiety Date: 2019-09-02 Impact factor: 6.505
Authors: Dharmendra B Goswami; Courtney S Jernigan; Agata Chandran; Abiye H Iyo; Warren L May; Mark C Austin; Craig A Stockmeier; Beata Karolewicz Journal: Prog Neuropsychopharmacol Biol Psychiatry Date: 2012-12-20 Impact factor: 5.067
Authors: Thiago M Fidalgo; J Leon Morales-Quezada; Guilherme S C Muzy; Noelle M Chiavetta; Mariana E Mendonca; Marcus V B Santana; Oscar F Goncalves; Andre R Brunoni; Felipe Fregni Journal: J ECT Date: 2014-03 Impact factor: 3.635