Personality dimensions and deep repetitive transcranial magnetic stimulation (DTMS) for treatment-resistant depression: a pilot trial on five-factor prediction of antidepressant response

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...

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Published in:	Neuroscience letters Vol. 563; pp. 144 - 148
Main Authors:	McGirr, Alexander, Van den Eynde, Frederique, Chachamovich, Eduardo, Fleck, Marcelo P A, Berlim, Marcelo T
Format:	Journal Article
Language:	English
Published:	Ireland 20-03-2014
Subjects:	Adult Anxiety Disorders - psychology Depressive Disorder, Major - diagnosis Depressive Disorder, Major - psychology Depressive Disorder, Major - therapy Extraversion (Psychology) Female Humans Male Middle Aged Neuroticism Personality Personality Assessment Pilot Projects Prognosis Prospective Studies Transcranial Magnetic Stimulation Treatment Outcome Deep transcranial magnetic stimulation Personality Transcranial magnetic stimulation Five-factor personality Major depression
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Abstract	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 (DTMS) allows stimulation of deeper cortical regions, and we aimed to prospectively characterize personality dimensions and antidepressant response to DTMS in treatment-resistant MDD. A convenience sample of 15 patients with treatment-resistant MDD received four weeks of daily sessions of DTMS (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. Four weeks of DTMS 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 extraversion were linearly associated with antidepressant response. Neuroticism was not associated with the antidepressant effects of DTMS in this cohort. Five-factor personality assessment may have prognostic value in DTMS for resistant MDD. Agreeableness, extraversion, and conscientiousness are associated with decreases in depressive symptoms during treatment with DTMS.
AbstractList	BACKGROUNDPrognostication 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 (DTMS) allows stimulation of deeper cortical regions, and we aimed to prospectively characterize personality dimensions and antidepressant response to DTMS in treatment-resistant MDD.METHODSA convenience sample of 15 patients with treatment-resistant MDD received four weeks of daily sessions of DTMS (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.RESULTSFour weeks of DTMS 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 extraversion were linearly associated with antidepressant response. Neuroticism was not associated with the antidepressant effects of DTMS in this cohort.CONCLUSIONSFive-factor personality assessment may have prognostic value in DTMS for resistant MDD. Agreeableness, extraversion, and conscientiousness are associated with decreases in depressive symptoms during treatment with DTMS. 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 (DTMS) allows stimulation of deeper cortical regions, and we aimed to prospectively characterize personality dimensions and antidepressant response to DTMS in treatment-resistant MDD. A convenience sample of 15 patients with treatment-resistant MDD received four weeks of daily sessions of DTMS (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. Four weeks of DTMS 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 extraversion were linearly associated with antidepressant response. Neuroticism was not associated with the antidepressant effects of DTMS in this cohort. Five-factor personality assessment may have prognostic value in DTMS for resistant MDD. Agreeableness, extraversion, and conscientiousness are associated with decreases in depressive symptoms during treatment with DTMS. 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 (DTMS) allows stimulation of deeper cortical regions, and we aimed to prospectively characterize personality dimensions and antidepressant response to DTMS in treatment-resistant MDD.
Author	Fleck, Marcelo P A Van den Eynde, Frederique Berlim, Marcelo T McGirr, Alexander Chachamovich, Eduardo
Author_xml	– sequence: 1 givenname: Alexander surname: McGirr fullname: McGirr, Alexander organization: Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada – sequence: 2 givenname: Frederique surname: Van den Eynde fullname: Van den Eynde, Frederique organization: Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, QC, Canada – sequence: 3 givenname: Eduardo surname: Chachamovich fullname: Chachamovich, Eduardo organization: Depressive Disorders Program, Douglas Mental Health University Institute and McGill University, Montréal, QC, Canada – sequence: 4 givenname: Marcelo P A surname: Fleck fullname: Fleck, Marcelo P A organization: Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, QC, Canada – sequence: 5 givenname: Marcelo T surname: Berlim fullname: Berlim, Marcelo T email: nrc.douglas@me.com organization: Depressive Disorders Program, Douglas Mental Health University Institute and McGill University, Montréal, QC, Canada; Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, QC, Canada. Electronic address: nrc.douglas@me.com
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/24486892$$D View this record in MEDLINE/PubMed
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Snippet	Prognostication is poor in repetitive transcranial magnetic stimulation (rTMS) treatment for major depressive disorder (MDD). Personality traits, particularly... BACKGROUNDPrognostication is poor in repetitive transcranial magnetic stimulation (rTMS) treatment for major depressive disorder (MDD). Personality traits,... Background: Prognostication is poor in repetitive transcranial magnetic stimulation (rTMS) treatment for major depressive disorder (MDD). Personality traits,...
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SubjectTerms	Adult Anxiety Disorders - psychology Depressive Disorder, Major - diagnosis Depressive Disorder, Major - psychology Depressive Disorder, Major - therapy Extraversion (Psychology) Female Humans Male Middle Aged Neuroticism Personality Personality Assessment Pilot Projects Prognosis Prospective Studies Transcranial Magnetic Stimulation Treatment Outcome
Title	Personality dimensions and deep repetitive transcranial magnetic stimulation (DTMS) for treatment-resistant depression: a pilot trial on five-factor prediction of antidepressant response
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