The Clinical Effects of 1 Hz and 10 Hz Transcranial Magnetic Stimulation on Suicidal Ideation in Adolescents With MDD

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Büyüktaşkın Tunçtürk D., Croarkin P. E., Lewis C. P., Nakonezny P. A., Ozger C., Felipe Garzon J., ...Daha Fazla

AACAP’S 2024 Annual Meeting, Washington, Amerika Birleşik Devletleri, 14 Ekim 2024, ss.191-192, (Tam Metin Bildiri)

Özet

Objectives

Prior research has examined 10 Hz transcranial magnetic stimulation (TMS) for the treatment of suicidal ideation in adolescents. This study sought to compare the clinical effects of 1 Hz and 10 Hz TMS treatment on suicidal ideation in adolescents with depression. It was hypothesized that adolescents treated with 1 Hz and 10 Hz TMS would have similar improvements in suicidal ideation.

Methods

Adolescents aged 12 to 18 years (N = 41) were randomized to 1 Hz or 10 Hz TMS with 6 weeks of treatment (30 sessions). The primary outcome was intensity of suicidal ideation, assessed weekly with the Columbia Suicide Severity Rating Scale (C-SSRS). An ordinal logistic regression model via a generalized estimating equation (GEE) analysis of repeated measures was first used to estimate the change in the intensity of suicidal ideation over the 6 weeks of acute TMS treatment without adjusting for the change in depression severity via Children’s Depression Rating Scale-Revised (CDRS-R) total score over the TMS treatment period. Then, in a separate ordinal logistic model, we adjusted for the change in depression severity (via CDRS-R total score, with item 13 removed, as a time-varying covariate). Age, sex at birth, and number of previously failed medications (measure of treatment resistance) were included as covariates in each model.

Results

Suicidal ideation intensity decreased with both 1 Hz and 10 Hz TMS treatments over 6 weeks ( p = .0016 and p = .0015) with no difference in decreases among the 2 doses of TMS ( p = .785). In adjusted models for change in depressive symptom severity, the changes in intensity of suicidal ideation in both treatment groups were nonsignificant.

Conclusions

This study suggests that 6 weeks of both 1 Hz and 10 Hz TMS treatment have favorable clinical effects on suicidal ideation through the improvement of depressive symptoms. Future studies should examine rapid dosing models of TMS for adolescents with suicidal ideation and biomarker-driven treatment approaches.