Abstract
Background: The evaluation of treatment response to antidepressant therapy commonly depends on neuropsychologic assessments, as there are currently no suitable biomarkers. Previous research has identified a panel of increased proteins in patients with major depressive disorder (MDD), including antithrombin III (ATIII), as potential biomarkers of depression.Methods: A total of 90 MDD patients were recruited. Of these, 74 patients received occipital repetitive transcranial magnetic stimulation (rTMS) as individualized, standard, or sham treatment for 5 days, and underwent the complete procedure, including clinical assessments, blood collection, and protein measurement.Results: After treatment, ATIII was significantly decreased in both the individualized and standard groups (both p < 0.001) relative to the sham group. In the individualized group, reduction in ATIII was associated with improvements in several neuropsychological assessments. Furthermore, ATIII at baseline in the standard group and after individualized rTMS showed good performance for evaluating or predicting the response to five-day treatment (AUC = 0.771, 95% CI, 0.571–0.971; AUC = 0.875, 95% CI, 0.714–1.000, respectively) and remission at follow-up (AUC = 0.736, 95% CI, 0.529–0.943; AUC = 0.828, 95% CI, 0.656–1.000, respectively). Lastly, both baseline ATIII and change in ATIII showed good predictive value for the 24-item Hamilton Depression Rating Scale at follow-up (p = 0.024 and 0.023, respectively).Conclusion: Our study revealed a reduction in ATIII after occipital rTMS in MDD patients and a relationship between change in ATIII and therapeutic response. Taken together, these findings provide evidence for the potential of ATIII as a biomarker for the evaluation and prediction of antidepressive effects.
Highlights
Major depressive disorder (MDD) is a mental illness characterized by low mood and anhedonia that affects 322 million people worldwide, leading to excess disability and mortality [1,2,3]
Patients suffering from the following disorders or diseases were excluded: (a) other DSM-IV axis I or axis II disorders; (b) organic brain diseases; (c) psychotic depression; (d) endocrine diseases with abnormal biochemical indexes or organ functions; (e) treatment-resistant depression treated by electroconvulsive shock or repetitive transcranial magnetic stimulation (rTMS) with adequate dosage and duration; and f. diseases that result in any contraindications to magnetic resonance imaging (MRI) or rTMS
A total of 16 patients were excluded from analysis for various reasons, which are detailed in Supplementary Figure 1
Summary
Major depressive disorder (MDD) is a mental illness characterized by low mood and anhedonia that affects 322 million people worldwide, leading to excess disability and mortality [1,2,3]. According to the World Health Organization, this common mental disorder will be responsible for the greatest burden of disease worldwide by 2030 [4]. Both biological factors and environmental milieu are related to the occurrence of depression [5, 6]; little is known about the physiopathological mechanisms underlying MDD. Previous research has identified a panel of increased proteins in patients with major depressive disorder (MDD), including antithrombin III (ATIII), as potential biomarkers of depression
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