1. Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder According to the Existing Psychiatric Comorbidity
- Author
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Alexander T. Sack, Po Han Chou, Hsin-An Chang, Yen Feng Lin, Wei Hung Chang, Kuan-Pin Su, Taishiro Kishimoto, Ming-Kuei Lu, and Che-Sheng Chu
- Subjects
medicine.medical_specialty ,ANTIDEPRESSANT EFFICACY ,Generalized anxiety disorder ,medicine.medical_treatment ,Repetitive transcranial magnetic stimulation ,DORSOLATERAL PREFRONTAL CORTEX ,NETWORK METAANALYSIS ,RTMS TREATMENT ,Review ,TBS ,behavioral disciplines and activities ,03 medical and health sciences ,Behavioral Neuroscience ,DOUBLE-BLIND ,0302 clinical medicine ,Physical medicine and rehabilitation ,POSTTRAUMATIC-STRESS-DISORDER ,Neuroimaging ,mental disorders ,rTMS ,medicine ,RESISTANT DEPRESSION ,Pharmacology (medical) ,Theta-burst stimulation ,HEART-RATE-VARIABILITY ,business.industry ,Depression ,Panic disorder ,medicine.disease ,030227 psychiatry ,Transcranial magnetic stimulation ,Dorsolateral prefrontal cortex ,Substance abuse ,Psychiatry and Mental health ,medicine.anatomical_structure ,Brain stimulation ,Major depressive disorder ,business ,030217 neurology & neurosurgery ,THERAPEUTIC-EFFICACY - Abstract
Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are evidenced-based treatments for patients with major depressive disorder (MDD) who fail to respond to standard first-line therapies. However, although various TMS protocols have been proven to be clinically effective, the response rate varies across clinical applications due to the heterogeneity of real-world psychiatric comorbidities, such as generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or substance use disorder, which are often observed in patients with MDD. Therefore, individualized treatment approaches are important to increase treatment response by assigning a given patient to the most optimal TMS treatment protocol based on his or her individual profile. This literature review summarizes different rTMS or TBS protocols that have been applied in researches investigating MDD patients with certain psychiatric comorbidities and discusses biomarkers that may be used to predict rTMS treatment response. Furthermore, we highlight the need for the validation of neuroimaging and electrophysiological biomarkers associated with rTMS treatment responses. Finally, we discuss on which directions future efforts should focus for developing the personalization of the treatment of depression with rTMS or iTBS. more...
- Published
- 2021
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