S152. Stimulating Young Minds: Investigating a Next Generation Treatment for Depression in Youth

Abstract

Background: One third of young depressed patients do not respond to antidepressants and are at risk for chronic treatment resistance. Repetitive transcranial magnetic stimulation (rTMS) is efficacious in treating depression, however, few studies have investigated patients at earlier stages of illness when providing optimal treatments are likely to result in better response outcomes. A subset of patients show inadequate response to rTMS and identifying features of patients that predict response is needed to inform personalised approaches. Methods: In this open-label study, 17 young inpatients and outpatients with depression (aged 18-30; 22±3.8) were recruited. Neuronavigationally targeted high frequency (10 Hz) rTMS was administered at 110% of resting motor threshold on the left DLPFC for 45 trains of 4 seconds for 20 sessions over 4 weeks. Clinical interview, cognitive assessment and, psychosocial self-report scales were carried out within 2 weeks pre- and post-treatment. Results: Paired-samples t-tests revealed that depression, anxiety and psychiatric symptoms were significantly reduced with rTMS treatment (all p&.05) but no significant changes in cognitive or psychosocial functioning were found (p>.05). Greater improvements in depressive symptoms were associated with better pre-treatment set-shifting performance (p&.05; r=.53). In patients with moderate-severe depression (n=9), greater improvements in psychiatric symptoms were associated with later age of illness onset (p&.05; r=.88). Conclusions: In keeping with the literature, rTMS improves depressive, anxiety and psychiatric symptoms in young people. These data suggest that cognition may have utility in predicting rTMS treatment response and targeting rTMS earlier in the course of illness may result in better response outcomes in young people with depression.