Baseline rumination levels as a predictor of response to repetitive transcranial magnetic stimulation in major depressive disorder
Bibliographic record
Abstract
Abstract Background: Pathological rumination is a cardinal symptom of major depressive disorder (MDD), resulting from default-mode network (DMN) hyperactivity. Higher baseline rumination have been associated with onset of MDD, and therapies aiming at reducing rumination lead to clinical improvement. Repetitive transcranial magnetic stimulation (rTMS) is effective for MDD and has been shown to normalize activity in the DMN. Objective: To examine whether baseline rumination levels is a useful predictor of response to rTMS in MDD. Methods: We conducted a retrospective chart review of 46 patients who received accelerated rTMS (arTMS) for MDD: 23 received a prolonged intermittent theta burst (piTBS) (1,800 pulses) protocol, and 23 received a high frequency (HF) 20Hz (3,000 pulses) protocol. Stimulation was delivered over the left dorsolateral prefrontal cortex (DLPFC) at 110-120% of the resting motor threshold (MT) using figure-8 coils. Outcomes were assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Ruminative Response Scale (RRS) (divided into brooding [B] and reflection [R] subscales). We performed correlation analysis to examine the relationship between percentage improvement in MADRS score and baseline rumination scores across both protocols, and for each protocol separately. Both groups were matched for age, sex, and baseline MADRS score. Results: Across both protocols, improvement on the MADRS and on the RRS were positively correlated (r=.424, P=.019). However, baseline rumination, B and R scores showed no correlation with improvement on the MADRS. Similar results were obtained for the piTBS group alone. In the HF group, higher baseline rumination was associated with better improvement of depressive symptoms, but the results were of borderline significance (r=-.489, P=.046). Results were more significant using the Reflection subscale (r=-.561, P=0.019). Conclusion: In MDD, higher baseline levels of rumination may be associated with better response to HF rTMS, but not piTBS. These results will need to be replicated in larger cohorts. Keywords: cognition, TMS, neuromodulation, brooding
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".