Use of the Temperament and Character Inventory to Predict Response to Repetitive Transcranial Magnetic Stimulation for Major Depression

被引:13
|
作者
Siddiqi, Shan H. [1 ]
Chockalingam, Ravikumar [1 ]
Cloninger, C. Robert [1 ]
Lenze, Eric J. [1 ]
Cristancho, Pilar [1 ]
机构
[1] Washington Univ, Sch Med, Dept Psychiat, POB 8134,660 S Euclid Ave, St Louis, MO 63110 USA
关键词
depression; major depressive disorder; temperament; character; Temperament and Character Inventory (TCI); transcranial magnetic stimulation (TMS); repetitive TMS (rTMS); dorsolateral prefrontal cortex; DORSOLATERAL PREFRONTAL CORTEX; MOTOR CORTICAL EXCITABILITY; DEFAULT MODE NETWORK; CLINICAL-RESPONSE; RTMS TREATMENT; ANTIDEPRESSANT RESPONSE; RESISTANT DEPRESSION; PERSONALITY; DISORDER; THERAPY;
D O I
10.1097/PRA.0000000000000150
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: The goal of this study was to investigate the utility of the Temperament and Character Inventory (TCI) in predicting antidepressant response to repetitive transcranial magnetic stimulation (rTMS). Background: Although rTMS of the dorsolateral prefrontal cortex is an established antidepressant treatment, little is known about predictors of response. The TCI measures multiple personality dimensions (harm avoidance, novelty seeking, reward dependence, persistence, self-directedness, self-transcendence, and cooperativeness), some of which have predicted response to pharmacotherapy and cognitive-behavioral therapy. A previous study suggested a possible association between self-directedness and response to rTMS in melancholic depression, although this was limited by the fact that melancholic depression is associated with a limited range of TCI profiles. Methods: Nineteen patients with a major depressive episode completed the TCI before a clinical course of rTMS over the dorsolateral prefrontal cortex. Treatment response was defined as >= 50% decrease in scores on the Hamilton Rating Scale for Depression (Ham-D). Baseline scores on each TCI dimension were compared between responders and nonresponders through analysis of variance. Pearson correlations were also calculated for temperament/character scores in comparison with percentage improvement in Ham-D scores. Results: Eleven of the 19 patients responded to rTMS. T-scores for persistence were significantly higher in responders than in nonresponders (P=0.022). Linear regression revealed a correlation between persistence scores and percentage improvement in Ham-D scores. Conclusions: Higher persistence scores predicted antidepressant response to rTMS. This may be explained by rTMS-induced enhancement of cortical excitability, which has been found to be decreased in patients with high persistence. Personality assessment that includes measurement of TCI persistence may be a useful component of precision medicine initiatives in rTMS for depression.
引用
收藏
页码:193 / 202
页数:10
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