INVESTIGATION OF PREDICTIVE FACTORS FOR CLINICAL REMISSION IN RESPONSE TO REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) TREATMENT IN DEPRESSIVE DISORDER

Year 2023, , 344 - 352, 23.09.2023

Özgen Özçelik , Buket Cinemre , Ali Erdoğan , Özmen Metin

https://doi.org/10.17343/sdutfd.1256800

Abstract

Objective
It was aimed to examine the socio-demographic
and clinical data of patients treated with Repetitive
Transcranial Magnetic Stimulation (rTMS) for
depressive disorder and to evaluate the relationship of
these data with remission response to rTMS treatment.
Material and Method: The medical records of 120
patients were evaluated retrospectively. Hamilton
Depression Scale (HAM-D), Beck Anxiety Scale (BAI),
and Richard-Campbell Sleep Scale (RCSQ) scores
were analyzed.
Results
60% (72/120) of the patients were women and the
mean age was 42.80±12.80 years. According to
the HAM-D scores (7 and below), 41.4% (46/111)
of the patients were in remission at the end of the
treatment. In addition, when the pre-treatment and
post-treatment scale scores were evaluated, HAM-D
scores and BAI scores decreased significantly after
treatment (respectively; p<0.001, p<0.001), while
RCSQ scores increased significantly after treatment
(p<0.001). Binary regression analysis was performed
to investigate the predictive factors for remission of
depressive symptoms after rTMS treatment. A high
HAM-D score at the beginning of the treatment showed
a negative predictive relationship with remission
(p<0.001), while a decrease in HAM-D scores at the
second week of treatment showed a positive predictive
relationship with remission (p=0.009).
Conclusion
We may suggest that rTMS treatment reduces
depression and anxiety symptoms and improves
sleep quality. In addition, it can be said that the
severe depression before the rTMS treatment reduces
the likelihood of going into remission, whereas the
decrease in the severity of depression observed in the
second week of the treatment increases this likelihood.

Keywords

Depression, Repetitive transcranial magnetic stimulation, rTMS, Predictive factors, Remission

DEPRESİF BOZUKLUKTA TEKRARLAYAN TRANSKRANİYAL MANYETİK STİMÜLASYON (RTMS) TEDAVİSİNE YANIT OLARAK KLİNİK REMİSYON İÇİN PREDİKTİF FAKTÖRLERİN ARAŞTIRILMASI

Abstract

Amaç
Depresif bozukluk nedeniyle Tekrarlayan Transkraniyal
Manyetik Stimülasyon (rTMS) tedavisi alan hastaların
sosyo-demografik ve klinik verilerinin incelenmesi
ve bu verilerin rTMS tedavisine verilen remisyon
yanıtı ile ilişkisinin değerlendirilmesi amaçlandı.
Gereç ve Yöntem
120 hastanın tıbbi kayıtları retrospektif olarak değerlendirildi.
Hamilton Depresyon Ölçeği (HAM-D), Beck
Anksiyete Ölçeği (BAÖ), Richard-Campbell Uyku Ölçeği
(RCUÖ) puanları analiz edildi.
Bulgular
Hastaların %60'ı (72/120) kadındı ve yaş ortalaması
42.80±12.80 idi. HAM-D skorlarına göre (7 ve altı)
hastaların %41,4'ü (46/111) tedavi sonunda remisyondaydı.
Ayrıca tedavi öncesi ve tedavi sonrası ölçek
puanları değerlendirildiğinde, tedavi sonrası HAM-D
puanları ve BAÖ puanları anlamlı olarak azalırken
(sırasıyla; p<0.001, p<0.001), tedavi sonrası RCUÖ
puanları anlamlı olarak arttı (p<0.001). rTMS tedavisi
ile remisyon yanıtını yordayan faktörleri araştırmak
üzere ikili regresyon analizi yapıldı. Tedavi başlangıcında
HAM-D skorunun yüksek olması remisyon ile
negatif prediktif ilişki gösterirken (p<0.001), tedavinin
ikinci haftasında HAM-D skorlarında azalma remisyon
ile pozitif prediktif ilişki gösterdi (p=0.009).
Sonuç
rTMS tedavisinin depresyon ve anksiyete belirtilerini
azalttığını ve uyku kalitesini iyileştirdiğini söyleyebiliriz.
Ayrıca rTMS tedavisi öncesi şiddetli depresyonun
remisyona girme olasılığını azalttığı, tedavinin ikinci
haftasında görülen depresyon şiddetindeki azalmanın
ise bu olasılığı artırdığı söylenebilir.

Keywords

Depresyon, Tekrarlayan transkraniyal manyetik stimülasyon, rTMS, Prediktif faktörler, Remisyon

Supporting Institution

YOK

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