The effects of rTMS on self-reported quality of life in younger and older adults with major depressive disorder
Bibliographic record
Abstract
Abstract Background Repetitive transcranial magnetic stimulation (rTMS) is a well-established intervention for treatment-resistant depression. However, its effects on patient-reported outcomes, such as quality of life (QoL), have not been fully characterized, especially among older adults. This study compares the impact of rTMS on QoL in younger (<60 years) versus older (≥60 years) adults with major depressive disorder. Methods We analyzed data from 531 participants with depression (ages 18–89 years) from two randomized clinical trials (THREE-D and FOUR-D). All participants received either unilateral or bilateral rTMS or theta burst stimulation. QoL was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form at baseline, end of treatment, and 12-week follow-up, and compared between younger adults (age < 60 years; n = 360) and older adults (age ≥ 60 years, n = 171). The clinical relevance of the changes was evaluated through effect sizes, using a predefined threshold of 12 points as the minimal clinically important difference, and comparisons with community norms. Results After rTMS treatment, both younger and older adults experienced statistically significant improvements in QoL, with medium to large effect sizes. The effect was sustained over 12 weeks of follow-up. At baseline, only 0.3% of younger adults and 2.3% of older adults reported normal QoL, which significantly increased to, respectively, 19.8 and 19.4% by the end of treatment, and 23.7 and 26.8% at the 12-week follow-up. Conclusions rTMS yielded acute and sustained clinically meaningful improvements in QoL, with similar effects among younger and older adults with depression. The magnitude of improvement was comparable to, or exceeded, that reported in antidepressant trials.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| 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 source (direct Gemma or distilled Codex), 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".