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. 2023 Sep 6;13(9):1289.
doi: 10.3390/brainsci13091289.

An Evaluation of the Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the Management of Treatment-Resistant Depression with Somatic Attributes: A Hospital-Based Study in Oman

Intisar Al-Ruhaili  1 , Salim Al-Huseini  2 , Said Al-Kaabi  2 , Sangeetha Mahadevan  3 , Nasser Al-Sibani  3 , Naser Al Balushi  3 , M Mazharul Islam  4 , Sachin Jose  5 , Gilda Kiani Mehr  6 , Samir Al-Adawi  3
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An Evaluation of the Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the Management of Treatment-Resistant Depression with Somatic Attributes: A Hospital-Based Study in Oman

Intisar Al-Ruhaili et al. Brain Sci. .

Abstract

Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, p < 0.0001, and 95% CI = 8.574-12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression.

Keywords: Hamilton Rating Scale for Depression; depressive illness; non-Western societies; non-pharmacological approaches; repetitive transcranial magnetic stimulation (rTMS); somatic attributes; treatment-resistant depression (TRD).

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of study participants.
Figure 2
Figure 2
Distribution of baseline and follow-up outcome measures based on Hamilton Rating Scale for Depression (HAMD) scores.
Figure 3
Figure 3
Change in individual and mean Hamilton Rating Scale for Depression (HAMD) scores after rTMS intervention with 95% confidence interval of mean scores.
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