Predictive values of pre-treatment brain age models to rTMS effects in neurocognitive disorder with depression: Secondary analysis of a randomised sham-controlled clinical trial.

IF 8.3 2区 医学 Q1 Medicine Dialogues in Clinical Neuroscience Pub Date : 2024-01-01 Epub Date: 2024-07-04 DOI:10.1080/19585969.2024.2373075
Hanna Lu, Jing Li, Sandra Sau Man Chan, Suk Ling Ma, Vincent Chung Tong Mok, Lin Shi, Arthur Dun-Ping Mak, Linda Chiu Wa Lam
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Abstract

Introduction: One major challenge in developing personalised repetitive transcranial magnetic stimulation (rTMS) is that the treatment responses exhibited high inter-individual variations. Brain morphometry might contribute to these variations. This study sought to determine whether individual's brain morphometry could predict the rTMS responders and remitters.

Methods: This was a secondary analysis of data from a randomised clinical trial that included fifty-five patients over the age of 60 with both comorbid depression and neurocognitive disorder. Based on magnetic resonance imaging scans, estimated brain age was calculated with morphometric features using a support vector machine. Brain-predicted age difference (brain-PAD) was computed as the difference between brain age and chronological age.

Results: The rTMS responders and remitters had younger brain age. Every additional year of brain-PAD decreased the odds of relieving depressive symptoms by ∼25.7% in responders (Odd ratio [OR] = 0.743, p = .045) and by ∼39.5% in remitters (OR = 0.605, p = .022) in active rTMS group. Using brain-PAD score as a feature, responder-nonresponder classification accuracies of 85% (3rd week) and 84% (12th week), respectively were achieved.

Conclusion: In elderly patients, younger brain age appears to be associated with better treatment responses to active rTMS. Pre-treatment brain age models informed by morphometry might be used as an indicator to stratify suitable patients for rTMS treatment.

Trial registration: ClinicalTrials.gov Identifier: ChiCTR-IOR-16008191.

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治疗前脑年龄模型对神经认知障碍伴抑郁症患者经颅磁刺激效应的预测价值:随机假对照临床试验的二次分析。
简介开发个性化重复经颅磁刺激(rTMS)的一个主要挑战是,治疗反应表现出很大的个体差异。大脑形态可能是造成这些差异的原因之一。本研究试图确定个体的大脑形态测量是否能预测经颅磁刺激的反应者和缓解者:本研究对一项随机临床试验的数据进行了二次分析,该试验包括 55 名 60 岁以上同时患有抑郁症和神经认知障碍的患者。根据磁共振成像扫描结果,利用支持向量机通过形态特征计算出估计脑龄。脑预测年龄差(brain-PAD)被计算为脑年龄与实际年龄之差:结果:经颅磁刺激反应者和缓解者的脑龄较小。积极经颅磁刺激组中,脑PAD每增加1岁,抑郁症状缓解的几率就降低25.7%(奇数比[OR] = 0.743,P = .045),缓解的几率降低39.5%(OR = 0.605,P = .022)。以脑PAD评分为特征,应答者-非应答者分类准确率分别达到85%(第3周)和84%(第12周):结论:在老年患者中,较年轻的脑龄似乎与对主动经颅磁刺激的较好治疗反应有关。以形态测量为依据的治疗前脑年龄模型可作为一项指标,对适合接受经颅磁刺激治疗的患者进行分层:试验注册:ClinicalTrials.gov Identifier:ChiCTR-IOR-16008191。
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来源期刊
Dialogues in Clinical Neuroscience
Dialogues in Clinical Neuroscience Medicine-Psychiatry and Mental Health
CiteScore
19.30
自引率
1.20%
发文量
1
期刊介绍: Dialogues in Clinical Neuroscience (DCNS) endeavors to bridge the gap between clinical neuropsychiatry and the neurosciences by offering state-of-the-art information and original insights into pertinent clinical, biological, and therapeutic aspects. As an open access journal, DCNS ensures accessibility to its content for all interested parties. Each issue is curated to include expert reviews, original articles, and brief reports, carefully selected to offer a comprehensive understanding of the evolving landscape in clinical neuroscience. Join us in advancing knowledge and fostering dialogue in this dynamic field.
期刊最新文献
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