Repetitive transcranial magnetic stimulation treatment of major depressive disorder and comorbid chronic pain: response rates and neurophysiologic biomarkers

Major depressive disorder (MDD) and chronic pain are highly comorbid, and pain symptoms are associated with a poorer response to antidepressant medication treatment. It is unclear whether comorbid pain also is associated with a poorer response to treatment with repetitive transcranial magnetic stimu...

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Bibliographic Details
Published in:Psychological medicine Vol. 53; no. 3; pp. 823 - 832
Main Authors: Corlier, Juliana, Tadayonnejad, Reza, Wilson, Andrew C, Lee, Jonathan C, Marder, Katharine G, Ginder, Nathaniel D, Wilke, Scott A, Levitt, Jennifer, Krantz, David, Leuchter, Andrew F
Format: Journal Article
Language:English
Published: Cambridge, UK Cambridge University Press 01.02.2023
Subjects:
Adult
Aged
Antidepressants
Between-subjects design
Biological markers
Biomarkers
Chronic pain
Chronic Pain - epidemiology
Chronic Pain - therapy
Clinical outcomes
Coherence
Comorbidity
Cortex
Depressive Disorder, Major - epidemiology
Depressive Disorder, Major - therapy
Depressive personality disorders
Drugs
EEG
Electroencephalography
Female
Gender
Humans
Magnetic fields
Male
Medical treatment
Mental depression
Middle Aged
Original
Original Article
Pain
Patients
Prefrontal cortex
Prefrontal Cortex - physiopathology
Response rates
Resting
Sensorimotor system
Severity
Somatosensory cortex
Stimuli
Symptoms
Transcranial Magnetic Stimulation
Treatment Outcome
peak alpha frequency (PAF)
Repetitive transcranial magnetic stimulation (rTMS)
phase coherence
Major depressive disorder (MDD)
Chronic Pain
ISSN:0033-2917, 1469-8978, 1469-8978
Online Access:Get full text
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Summary:Major depressive disorder (MDD) and chronic pain are highly comorbid, and pain symptoms are associated with a poorer response to antidepressant medication treatment. It is unclear whether comorbid pain also is associated with a poorer response to treatment with repetitive transcranial magnetic stimulation (rTMS). 162 MDD subjects received 30 sessions of 10 Hz rTMS treatment administered to the left dorsolateral prefrontal cortex (DLPFC) with depression and pain symptoms measured before and after treatment. For a subset of 96 patients, a resting-state electroencephalogram (EEG) was recorded at baseline. Clinical outcome was compared between subjects with and without comorbid pain, and the relationships among outcome, pain severity, individual peak alpha frequency (PAF), and PAF phase-coherence in the EEG were examined. 64.8% of all subjects reported pain, and both depressive and pain symptoms were significantly reduced after rTMS treatment, irrespective of age or gender. Patients with severe pain were 27% less likely to respond to MDD treatment than pain-free individuals. PAF was positively associated with pain severity. PAF phase-coherence in the somatosensory and default mode networks was significantly lower for MDD subjects with pain who failed to respond to MDD treatment. Pain symptoms improved after rTMS to left DLPFC in MDD irrespective of age or gender, although the presence of chronic pain symptoms reduced the likelihood of treatment response. Individual PAF and baseline phase-coherence in the sensorimotor and midline regions may represent predictors of rTMS treatment outcome in comorbid pain and MDD.
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ISSN:0033-2917
1469-8978
1469-8978
DOI:10.1017/S0033291721002178