Childhood Trauma May Impact TMS Treatment Outcomes

Certain types of adverse childhood life events and trauma may impact transcranial magnetic stimulation (TMS) treatment outcomes more than others, according to a study presented in a poster session at the Anxiety and Depression Association of America 2021 Virtual Conference.

Researchers from Butler Hospital Neuromodulation Research Facility, Providence, Rhode Island, and Brown University, Providence, Rhode Island, analyzed data from 117 clinic patients who completed the childhood trauma questionnaire (CTQ). The CTQ assessed the severity and type of childhood trauma exposure in a naturalistic setting from patients receiving standard, repetitive TMS for treatment-resistant major depressive disorder (MDD). The 5 types of adverse events on the questionnaire were physical abuse, emotional abuse, physical neglect, emotional neglect, and sexual abuse.

The Inventory of Depressive Symptomatology Self-Report (IDS-SR) was used to measure severity of depression, clinical response, and remission.

Youth Trauma Linked With Brain Alterations in Adults With MDD

“Higher severity of trauma history was associated with more severe depression at baseline and with less improvement with TMS,” researchers wrote.

This was demonstrated by a statistically significant negative correlation between IDS-SR percent change and CTQ overall total score. More specifically, patients with more physical abuse and physical neglect had less improvement in depression.

Compared to responders, nonresponders had significantly higher scores in physical abuse sexual abuse, and physical neglect. “However, history of moderate to severe trauma did not predict non-response or non-remission,” researchers wrote.

“Biological pathways and mechanisms in depressed patients with certain types of childhood trauma could lead to personalized treatment algorithm leading to improved efficacy with TMS therapy,” they wrote in the poster.

—Meagan Thistle

Reference

Fukada A, Beck Q, Tirrell E, et al. Impact of early adverse life events on clinical outcome of transcranial magnetic stimulation for depression. Poster presented at the Anxiety and Depression Association of America 2021 Virtual Conference; March 18, 2021; Virtual.