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A Dose-Finding, Biomarker Validation, and Effectiveness Study of Transcranial Magnetic Stimulation for Adolescents With Depression.
Lewis, Charles P; Nakonezny, Paul A; Sonmez, Ayse Irem; Ozger, Can; Garzon, Juan F; Camsari, Deniz Doruk; Yuruk, Deniz; Romanowicz, Magdalena; Shekunov, Julia; Zaccariello, Michael J; Vande Voort, Jennifer L; Croarkin, Paul E.
Afiliación
  • Lewis CP; University of Minnesota, Minneapolis, Minnesota; Mayo Clinic, Rochester, Minnesota.
  • Nakonezny PA; University of Texas Southwestern Medical Center, Dallas, Texas.
  • Sonmez AI; Mayo Clinic, Rochester, Minnesota; Columbia University, New York, New York.
  • Ozger C; Mayo Clinic, Rochester, Minnesota.
  • Garzon JF; Mayo Clinic, Rochester, Minnesota.
  • Camsari DD; Mayo Clinic, Rochester, Minnesota.
  • Yuruk D; Mayo Clinic, Rochester, Minnesota.
  • Romanowicz M; Mayo Clinic, Rochester, Minnesota.
  • Shekunov J; Mayo Clinic, Rochester, Minnesota.
  • Zaccariello MJ; Mayo Clinic, Rochester, Minnesota.
  • Vande Voort JL; Mayo Clinic, Rochester, Minnesota.
  • Croarkin PE; Mayo Clinic, Rochester, Minnesota. Electronic address: croarkin.paul@mayo.edu.
J Am Acad Child Adolesc Psychiatry ; 2024 Sep 04.
Article en En | MEDLINE | ID: mdl-39245178
ABSTRACT

OBJECTIVE:

Research and clinical application of transcranial magnetic stimulation (TMS) for adolescents with major depressive disorder (MDD) has advanced slowly. Significant gaps persist in our understanding of optimized, age-specific protocols and dosing strategies. This study aimed to compare the clinical effects of 1 Hz versus 10 Hz TMS regimens and examine a biomarker-informed treatment approach with glutamatergic intracortical facilitation (ICF).

METHOD:

Participants with moderate-to-severe symptoms of MDD were randomized to 30 sessions of left prefrontal 1 Hz or 10 Hz TMS, stratified by baseline ICF measures. The primary clinical outcome measure was the Children's Depression Rating Scale, Revised (CDRS-R). The CDRS-R and ICF biomarker were collected weekly.

RESULTS:

Forty-one participants received either 1 Hz (n = 22) or 10 Hz (n = 19) TMS treatments. CDRS-R scores improved compared to baseline in both 1 Hz and 10 Hz groups. For participants with low ICF at baseline, the overall least squares means of CDRS-R scores over the 6-week trial showed that depressive symptom severity was lower for the group treated with 1 Hz TMS than for those who received 10 Hz TMS. There were no significant changes in weekly ICF measurements across the 6 weeks of TMS treatment.

CONCLUSION:

Low ICF may reflect optimal glutamatergic N-methyl-d-aspartate (NMDA) receptor activity that facilitates the therapeutic effect of 1 Hz TMS through long-term depression-like mechanisms on synaptic plasticity. The stability of ICF suggests that it is a tonic, trait-like measure of NMDA receptor-mediated neurotransmission, with potential utility to inform parameter selection for therapeutic TMS in adolescents with MDD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Acad Child Adolesc Psychiatry Asunto de la revista: PEDIATRIA / PSIQUIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Acad Child Adolesc Psychiatry Asunto de la revista: PEDIATRIA / PSIQUIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos