Abstract
Abstract Introduction As part of a larger study to examine the effects of repetitive transcranial magnetic stimulation (rTMS) over a single node of the default mode network (DMN) on sleep quality, we also examined secondary effects on depression. We hypothesized that rTMS would be more effective in females, rather than males, due to previously established higher rates of depression in the female population. Methods We administered continuous theta burst stimulation (cTBS) rTMS or sham stimulation, in a counterbalanced order separated by at least 5 days, over the left inferior parietal node of the DMN in 20 participants with clinical insomnia, 8 males (Mage=31.6, SD=6.7) and 12 females (Mage=23.8, SD=4.3). Beck Depression Inventory (BDI) scores obtained immediately before and after the stimulation sessions were compared using mixed (condition x time x sex) ANOVA to determine the effectiveness of rTMS in reducing symptoms of depression between the sexes. Results Overall, there was a large effect size (ηp2=0.207, p=0.077) in BDI scores between scores after the sham cTBS TMS session (M=12.47, SD=2.54) and scores after the active cTBS TMS session (M=10.00, SD=2.01). However, when separating for sex, males did not show a statistically significant reduction in depressive symptoms for the active session compared to the sham session (ηp2=0.08, F(1,6)=19.00, p=0.508). While the treatment did not significantly change depressive symptoms in females, large effect size was observed (ηp2=0.261, F(1,7)=18.06, p=0.16), suggesting potential efficacy of the treatment. Post-hoc pairwise comparisons reveal a greater change in depression symptom scores for active vs sham cTBS TMS in women (M=-4.00, SD=2.00), than men (M=-0.71, SD=1.43). Conclusion An intervention using cTBS rTMS to improve sleep also led to a trend toward reduced depression, that was more evident among women. As reported elsewhere, this treatment significantly improved polysomnographic sleep, and the present preliminary results suggest that it may also be useful for modestly improving depressive mood, but further research will be necessary due to the limited sample size. It is not clear whether the trends toward mood among women was due simply to higher baseline depression scores in that group, but the findings suggest that additional work is warranted. Support (if any) W81XWH2010173
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