TY - JOUR
T1 - In Older Adults the Antidepressant Effect of Repetitive Transcranial Magnetic Stimulation Is Similar but Occurs Later Than in Younger Adults
AU - Cotovio, Gonçalo
AU - Boes, Aaron D.
AU - Press, Daniel Z.
AU - Oliveira-Maia, Albino J.
AU - Pascual-Leone, Alvaro
N1 - Funding Information:
AJO-M was the national coordinator for Portugal of a non-interventional study (EDMS-ERI-143085581, 4.0) to characterize a Treatment-Resistant Depression Cohort in Europe, sponsored by Janssen-Cilag, Ltd (2019–2020), is the recipient of a grant from Schuhfried GmBH for norming and validation of cognitive tests, and is the national coordinator for Portugal of trials of psilocybin therapy for treatment-resistant depression, sponsored by Compass Pathways, Ltd (EudraCT number 2017-003288-36), and of esketamine for treatment-resistant depression, sponsored by the Janssen-Cilag, Ltd (EudraCT NUMBER: 2019-002992-33). AP-L is a co-founder of Linus Health and TI Solutions AG; serves on the scientific advisory boards for Starlab Neuroscience, Magstim Inc., Radiant Hearts, and MedRhythms; and is listed as an inventor on several issued and pending patents on the real-time integration of non-invasive brain stimulation with electroencephalography and magnetic resonance imaging. None of the aforementioned agencies or companies had a role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, in the preparation, review, or approval of the manuscript, nor in the decision to submit the manuscript for publication. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Funding Information:
GC was funded by the Fundação para a Ciência e Tecnologia (FCT; Portugal) through a PhD Scholarship (SFRH/BD/130210/2017). AB was supported by the NIH (NS114405-02, MH120441-01). AJO-M was funded by the FCT (Portugal) through a Junior Research and Career Development Award from the Harvard Medical School—Portugal Program (HMSP-ICJ/0020/2011). GC and AJO-M were supported by grant PTDC/MED-NEU/31331/2017, and AJO-M by grant PTDC/MED-NEU/30302/2017, funded by national funds from FCT/MCTES and co-funded by FEDER, under the Partnership Agreement Lisboa 2020—Programa Operacional Regional de Lisboa. AJO-M was also funded by a Starting Grant from the European Research Council under the European Union's Horizon 2020 research and innovation program (Grant Agreement No. 950357).
Publisher Copyright:
Copyright © 2022 Cotovio, Boes, Press, Oliveira-Maia and Pascual-Leone.
PY - 2022/7/19
Y1 - 2022/7/19
N2 - Background: Treatment resistant depression is common in older adults and treatment is often complicated by medical comorbidities and polypharmacy. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option for this group due to its favorable profile. However, early influential studies suggested that rTMS is less effective in older adults. This evidence remains controversial. Methods: Here, we evaluated the rTMS treatment outcomes in a large international multicenter naturalistic cohort of >500 patients comparing older vs. younger adults. Results: We show that older adults, while having similar antidepressant response to younger adults, respond more slowly, which may help to explain differences from earlier studies when the duration of a treatment course was shorter. Conclusions: Such evidence helps to resolve a long-standing controversy in treating older depressed patients with rTMS. Moreover, these findings provide an important data point in the call to revise policy decisions from major insurance providers that have unfairly excluded older adults.
AB - Background: Treatment resistant depression is common in older adults and treatment is often complicated by medical comorbidities and polypharmacy. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option for this group due to its favorable profile. However, early influential studies suggested that rTMS is less effective in older adults. This evidence remains controversial. Methods: Here, we evaluated the rTMS treatment outcomes in a large international multicenter naturalistic cohort of >500 patients comparing older vs. younger adults. Results: We show that older adults, while having similar antidepressant response to younger adults, respond more slowly, which may help to explain differences from earlier studies when the duration of a treatment course was shorter. Conclusions: Such evidence helps to resolve a long-standing controversy in treating older depressed patients with rTMS. Moreover, these findings provide an important data point in the call to revise policy decisions from major insurance providers that have unfairly excluded older adults.
KW - depression
KW - efficacy
KW - naturalistic study
KW - older adults
KW - transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=85135237668&partnerID=8YFLogxK
U2 - 10.3389/fnagi.2022.919734
DO - 10.3389/fnagi.2022.919734
M3 - Article
C2 - 35928992
AN - SCOPUS:85135237668
SN - 1663-4365
VL - 14
JO - FRONTIERS IN AGING NEUROSCIENCE
JF - FRONTIERS IN AGING NEUROSCIENCE
M1 - 919734
ER -