Optimizing prefrontal repetitive transcranial magnetic stimulation as a treatment for depression - Which parameters predict a response?

rTMS is considered to be a putative treatment option for those depressive patients being refractory or intolerant to other antidepressant treatment forms. Overall, published studies show a significant reduction in depressive symptomatology due to rTMS, but the clinical significance of the therapeutic changes were only modest. Therefore, studies to optimize the efficacy of US are necessary. In the Berlin Predictor Study rTMS treatment of the left dorso, lateral prefrontal cortex was performed in 70 patients of whom 21% showed an antidepressant response. Since individual clinical symptom clusters were of special interest, five clusters are analyzed during course of the treatment. By using a logistic regression model it could be shown that beside general predictors like short duration of episode and low level of therapy resistance, especially motor retardation and sleep disturbances are clinical predictors for a response to rTMS.