The relationship between pre-treatment heart rate variability and response to low-frequency accelerated repetitive transcranial magnetic stimulation in major depression

Jean-Philippe Miron; Jack Sheen; Tony Panzarella; Molly Hyde; Farrokh Mansouri; Linsay Fox; Helena Voetterl; Véronique Desbeaumes Jodoin; Paul Lespérance; Christophe Longpré-Poirier; Robert-Paul Juster; Zafiris J. Daskalakis; Daniel M. Blumberger; Jonathan Downar

Journal of Affective Disorders Reports (Dec 2021)

The relationship between pre-treatment heart rate variability and response to low-frequency accelerated repetitive transcranial magnetic stimulation in major depression

Jean-Philippe Miron,
Jack Sheen,
Tony Panzarella,
Molly Hyde,
Farrokh Mansouri,
Linsay Fox,
Helena Voetterl,
Véronique Desbeaumes Jodoin,
Paul Lespérance,
Christophe Longpré-Poirier,
Robert-Paul Juster,
Zafiris J. Daskalakis,
Daniel M. Blumberger,
Jonathan Downar

Affiliations

Jean-Philippe Miron: Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de Recherche du CHUM (CRCHUM), Université de Montréal, QC, Canada; Département de Psychiatrie et d'Addictologie, Faculté de Médecine, Université de Montréal, QC, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, ON, Canada; Corresponding author.
Jack Sheen: Institute of Medical Science, Faculty of Medicine, University of Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada
Tony Panzarella: Dalla Lana School of Public Health, University of Toronto, ON, Canada
Molly Hyde: Institute of Medical Science, Faculty of Medicine, University of Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada
Farrokh Mansouri: Institute of Medical Science, Faculty of Medicine, University of Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada
Linsay Fox: Krembil Research Institute, University Health Network, Toronto, ON, Canada
Helena Voetterl: Research Institute Brainclinics, Nijmegen and Department of Psychiatry, University of Amsterdam, the Netherlands
Véronique Desbeaumes Jodoin: Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de Recherche du CHUM (CRCHUM), Université de Montréal, QC, Canada
Paul Lespérance: Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de Recherche du CHUM (CRCHUM), Université de Montréal, QC, Canada; Département de Psychiatrie et d'Addictologie, Faculté de Médecine, Université de Montréal, QC, Canada
Christophe Longpré-Poirier: Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de Recherche du CHUM (CRCHUM), Université de Montréal, QC, Canada; Département de Psychiatrie et d'Addictologie, Faculté de Médecine, Université de Montréal, QC, Canada
Robert-Paul Juster: Département de Psychiatrie et d'Addictologie, Faculté de Médecine, Université de Montréal, QC, Canada
Zafiris J. Daskalakis: Institute of Medical Science, Faculty of Medicine, University of Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, California, USA; Temerty Centre for Therapeutic Brain Intervention at the Centre for Addiction and Mental Health, Toronto, ON, Canada
Daniel M. Blumberger: Institute of Medical Science, Faculty of Medicine, University of Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention at the Centre for Addiction and Mental Health, Toronto, ON, Canada
Jonathan Downar: Institute of Medical Science, Faculty of Medicine, University of Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, ON, Canada

Journal volume & issue: Vol. 6
p. 100270

Abstract

Read online

Background: Major depressive disorder (MDD) is now the first cause of disability worldwide. So far, no validated and scalable biomarker has been identified to help with response prediction to antidepressant treatment. Cardiac biomarkers such as heart rate variability (HRV) have been studied in MDD, but few studies have examined its potential use for outcome prediction to repetitive transcranial magnetic stimulation (rTMS). Objective: We recorded pre-treatment HRV in MDD participants prior to an rTMS course. We hypothesized that higher pre-treatment HRV would be correlated with better clinical outcomes. Methods: HRV was recorded as part of a single-arm, open-label rTMS feasibility study. Pre-treatment HRV was assessed in N = 30 MDD participants before they underwent a one-week (5 days, 8 daily sessions, 40 sessions total) accelerated rTMS (arTMS) course using a low-frequency 1 Hz course (600 pulses per session, 50-minute intersession interval) over the right dorsolateral prefrontal cortex at 120% of the resting motor threshold. Clinical outcomes were captured using the Beck Depression Inventory-II (BDI-II). We tested for an association between pre-treatment HRV and clinical outcomes on the BDI-II using a linear mixed effects model. Results: Although average BDI-II score significantly changed over time, these changes were not significantly associated with pre-treatment HRV (p = 0.60). This finding remained when adjusting for age, sex, and HR, individually and collectively. Conclusion: The current study did not find a relationship between pre-treatment HRV and response to low frequency rTMS. Other approaches using cardiac biomarkers may have potential for response prediction.

Published in Journal of Affective Disorders Reports

ISSN: 2666-9153 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Other systems of medicine: Mental healing
Website: https://www.journals.elsevier.com/journal-of-affective-disorders-reports

About the journal

Abstract

Keywords