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Connectivity-guided intermittent theta burst versus repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled trial.
Morriss, Richard; Briley, Paul M; Webster, Lucy; Abdelghani, Mohamed; Barber, Shaun; Bates, Peter; Brookes, Cassandra; Hall, Beth; Ingram, Luke; Kurkar, Micheal; Lankappa, Sudheer; Liddle, Peter F; McAllister-Williams, R Hamish; O'Neil-Kerr, Alexander; Pszczolkowski, Stefan; Suazo Di Paola, Ana; Walters, Yvette; Auer, Dorothee P.
Afiliación
  • Morriss R; Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK. richard.morriss@nottingham.ac.uk.
  • Briley PM; Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
  • Webster L; Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
  • Abdelghani M; Clinical Neuromodulation Service, Camden and Islington NHS Foundation Trust, London, UK.
  • Barber S; Leicester Clinical Trials Unit, University of Leicester, Leicester, UK.
  • Bates P; Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
  • Brookes C; Leicester Clinical Trials Unit, University of Leicester, Leicester, UK.
  • Hall B; Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
  • Ingram L; Leicester Clinical Trials Unit, University of Leicester, Leicester, UK.
  • Kurkar M; Pennine Care TMS Service, Pennine Care NHS Foundation Trust, Oldham, UK.
  • Lankappa S; Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
  • Liddle PF; Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
  • McAllister-Williams RH; Northern Centre for Mood Disorders, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
  • O'Neil-Kerr A; Centre for Neuromodulation, Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK.
  • Pszczolkowski S; Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
  • Suazo Di Paola A; Leicester Clinical Trials Unit, University of Leicester, Leicester, UK.
  • Walters Y; Leicester Clinical Trials Unit, University of Leicester, Leicester, UK.
  • Auer DP; Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
Nat Med ; 30(2): 403-413, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38228914
ABSTRACT
Disruption in reciprocal connectivity between the right anterior insula and the left dorsolateral prefrontal cortex is associated with depression and may be a target for neuromodulation. In a five-center, parallel, double-blind, randomized controlled trial we personalized resting-state functional magnetic resonance imaging neuronavigated connectivity-guided intermittent theta burst stimulation (cgiTBS) at a site based on effective connectivity from the right anterior insula to the left dorsolateral prefrontal cortex. We tested its efficacy in reducing the primary outcome depression symptoms measured by the GRID Hamilton Depression Rating Scale 17-item over 8, 16 and 26 weeks, compared with structural magnetic resonance imaging (MRI) neuronavigated repetitive transcranial magnetic stimulation (rTMS) delivered at the standard stimulation site (F3) in patients with 'treatment-resistant depression'. Participants were randomly assigned to 20 sessions over 4-6 weeks of either cgiTBS (n = 128) or rTMS (n = 127) with resting-state functional MRI at baseline and 16 weeks. Persistent decreases in depressive symptoms were seen over 26 weeks, with no differences between arms on the primary outcome GRID Hamilton Depression Rating Scale 17-item score (intention-to-treat adjusted mean, -0.31, 95% confidence interval (CI) -1.87, 1.24, P = 0.689). Two serious adverse events were possibly related to TMS (mania and psychosis). MRI-neuronavigated cgiTBS and rTMS were equally effective in patients with treatment-resistant depression over 26 weeks (trial registration no. ISRCTN19674644).
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Estimulación Magnética Transcraneal / Trastorno Depresivo Resistente al Tratamiento Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Nat Med Asunto de la revista: BIOLOGIA MOLECULAR / MEDICINA Año: 2024 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Estimulación Magnética Transcraneal / Trastorno Depresivo Resistente al Tratamiento Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Nat Med Asunto de la revista: BIOLOGIA MOLECULAR / MEDICINA Año: 2024 Tipo del documento: Article