Personality Dimensions and Deep Repetitive Transcranial Magnetic Stimulation (Deep TMS) for Treatment-Resistant Depression: A Pilot Trial on Five-Factor Prediction of Antidepressant Response

Journal: Neuroscience Letters563:144-8(2014)

Authors: A McGirr, F Van den Eynde, E.C Chachamovich, M.P.A Fleck, M.T Berlim

Background:

Prognostication is poor in repetitive transcranial magnetic stimulation (rTMS) treatment for major depressive disorder (MDD). Personality traits, particularly extraversion and neuroticism, have attracted increasing attention for both trait-and state-dependent characteristics in predicting response to pharmacotherapy, psychotherapy, and more recently to therapeutic neuromodulation for MDD. The advent of deep rTMS (Deep TMS™) allows stimulation of deeper cortical regions.

Objective:

This study aimed to prospectively characterize personality dimensions and antidepressant response to Deep TMS in treatment-resistant MDD.

Methods:

A convenience sample of 15 patients with treatment-resistant MDD received four weeks of daily sessions of Deep TMS (20 Hz, 3000 pulses/session) of the left dorsolateral prefrontal cortex (DLFPC). At baseline and at the conclusion of treatment, patients completed the Big Five Inventory a five-factor assessment of major personality dimensions. Clinical response was measured using the 21-item Hamilton Depression Rating Scale.

Results:

Four weeks of Deep TMS treatment were not associated with changes in personality measures. Clinical remission was associated with higher baseline levels of agreeableness (score ≥29:100% sensitive and 72.7% specific) and conscientiousness (score ≥30:75% sensitive and 81.8% specific). Levels of agreeableness and extra version were linearly associated with antidepressant response. Neuroticism was not associated with the antidepressant effects of Deep TMS in this cohort.

Conclusions:

Five-factor personality assessment may have prognostic value in Deep TMS for resistant MDD. Agreeableness, extra version, and conscientiousness are associated with decreases in depressive symptoms during treatment with Deep TMS.

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