Responders to rTMS for depression show increased fronto-midline theta and theta connectivity compared to non-responders

Bailey, N.W.; Hoy, K.E.; Rogasch, N.C.; Thomson, R.H.; McQueen, S.; Elliot, D.; Sullivan, C.M.; Fulcher, B.D.; Daskalakis, Z.J.; Fitzgerald, P.B.

doi:10.1016/j.brs.2017.10.015

Cited by 162Transcranial Magnetic Stimulation StudiesTreatment of Major DepressionElectroconvulsive Therapy Studies

Responders to rTMS for depression show increased fronto-midline theta and theta connectivity compared to non-responders

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Bailey, N.W., Hoy, K.E., Rogasch, N.C., Thomson, R.H., McQueen, S., Elliot, D., Sullivan, C.M., Fulcher, B.D. +2 more·2018·Brain Stimulation

DOI 10.1016/j.brs.2017.10.015

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Abstract

Background Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression, but only some individuals respond. Predicting response could reduce patient and clinical burden. Neural activity related to working memory (WM) has been related to mood improvements, so may represent a biomarker for response prediction.Primary hypotheses We expected higher theta and alpha activity in responders compared to non-responders to rTMS.Methods Fifty patients with treatment resistant depression and twenty controls performed a WM task while electroencephalography (EEG) was recorded. Patients underwent 5-8 weeks of rTMS treatment, repeating the EEG at week 1 (W1). Of the 39 participants with valid WM-related EEG data from baseline and W1, 10 were responders. Comparisons between responders and non-responders were made at baseline and W1 for measures of theta (4-8 Hz), upper alpha (10-12.5 Hz), and gamma (30-45 Hz) power, connectivity, and theta-gamma coupling. The control group's measures were compared to the depression group's baseline measures separately.Results Responders showed higher levels of WM-related fronto-midline theta power and theta connectivity compared to non-responders at baseline and W1. Responder's fronto-midline theta power and connectivity was similar to controls. Responders also showed an increase in gamma connectivity from baseline to W1, with a concurrent improvement in mood and WM reaction times. An unbiased combination of all measures provided mean sensitivity of 0.90 at predicting responders and specificity of 0.92 in a predictive machine learning algorithm.Conclusion Baseline and W1 fronto-midline theta power and theta connectivity show good potential for predicting response to rTMS treatment for depression.

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In non-invasive brain stimulation and other intervention studies, non-responders are routinely excluded or treated differently.
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“Acc F1 Other Section A. Predicting TRD patients’ response to additional treatment Bailey et al. (2018) Linear support vector machine (SVM) classifier with 5-fold cross-validation Cross-validation Yes 0.92* 0.91* 0.91 0.93 10 responders of 39, prevalence = 0.2564 Bailey et al. (2019) Linear support…”
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Self-citation

Differentiating responders and non-responders to rTMS treatment for depression after one week using resting EEG connectivity measures
Bailey, N. W., Hoy, K. E., Rogasch, N. C., Thomson, R. H., McQueen, S., Elliot, D., Sullivan, C., Fulcher, B., Daskalakis, Z. J., & Fitzgerald, P. B. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.08.058 · Cited by 91 · see citing works
Self-citation
Resting EEG theta connectivity and alpha power to predict repetitive transcranial magnetic stimulation response in depression: A non-replication from the ICON-DB consortium
Bailey, N. W., Krepel, N., van Dijk, H., Leuchter, A. F., Vila‐Rodriguez, F., Blumberger, D. M., Downar, J. H., Wilson, A. C., Daskalakis, Z. J., Carpenter, L. L., et al. (2020) · Clinical Neurophysiology · doi:10.1016/j.clinph.2020.10.018 · Cited by 35 · see citing works
Self-citation
Use of machine learning in predicting the efficacy of repetitive transcranial magnetic stimulation on treating depression based on functional and structural thalamo-prefrontal connectivity: A pilot study
Chen, D., Lei, X., Du, L., & Long, Z. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.01.064 · Cited by 19 · see citing works
Concurrent transcranial magnetic stimulation and electroencephalography measures are associated with antidepressant response from rTMS treatment for depression
Bailey, N. W., Hoy, K. E., Sullivan, C. M., Allman, B., Rogasch, N. C., Daskalakis, Z. J., & Fitzgerald, P. B. (2023) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2023.100612 · Cited by 5 · see citing works
Self-citation
Neurophysiological predictors of non-response to rTMS in depression
Arns, M., Drinkenburg, W. H. I. M., Fitzgerald, P. B., & Kenemans, J. L. (2012) · Brain stimulation · doi:10.1016/j.brs.2011.12.003 · Cited by 196 · see citing works
Self-citation

Authors: Bailey, N. W., Hoy, K. E., Rogasch, N. C., Thomson, R. H., McQueen, S., Elliot, D., Sullivan, C. M., Fulcher, B. D., Daskalakis, Z. J., & Fitzgerald, P. B.
Affiliations: Monash Alfred Psychiatry Research centre (AU)
Monash University (AU)
Centre for Addiction and Mental Health (CA)
Epworth Hospital (AU)
Corresponding author: Bailey, N.W.
ORCID: Bailey, N.W.
Hoy, K.E.
Rogasch, N.C.
Thomson, R.H.
Sullivan, C.M.
Fulcher, B.D.
Daskalakis, Z.J.
Fitzgerald, P.B.
Venue: Brain Stimulation
Publisher: Elsevier BV
Published: 2018-01
Volume: 11
Issue: 1
Pages: 190-203
ISSN: 1876-4754 (ISSN-L)
1935-861X
DOI: 10.1016/j.brs.2017.10.015
OpenAlex: W2765484337
Cited by: 162
References: 80
Citations by year: 2026: 11 · 2025: 16 · 2024: 15 · 2023: 32 · 2022: 13 · 2021: 37 · 2020: 14 · 2019: 20 · 2018: 4
FWCI: 5.15
Type: journal article
Language: en
Open access: green
doaj.org
Licence: cc-by-sa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Brain stimulation (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: National Health and Medical Research Council (6069070)
Topics: Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords: repetitive transcranial magnetic stimulation, treatment-resistant depression, treatment response prediction, working memory, EEG biomarkers, theta-gamma coupling, alpha power, machine learning prediction
MeSH terms: Adolescent, Adult, Affect, Aged, Depression, Depressive Disorder, Electroencephalography, Female, Humans, Male, Memory, Short-Term, Middle Aged, Reaction Time, Theta Rhythm, Case-Control Studies, Treatment Outcome, Transcranial Magnetic Stimulation, Young Adult

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Responders to rTMS for depression show increased fronto-midline theta and theta connectivity compared to non-responders

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