Indicators for Remission of Suicidal Ideation Following Magnetic Seizure Therapy in Patients With Treatment-Resistant Depression

作者：Yinming Sun, Faranak Farzan, Benoit H. Mulsant, Tarek K. Rajji, Paul Bernard Fitzgerald, Mera S. Barr, Jonathan H. Downar, Willy Wong, Daniel M. Blumberger, Zafiris Jeff Daskalakis · 发表于：JAMA Psychiatry · 年份：2016 · DOI：10.1001/jamapsychiatry.2015.3097 · 被引用次数：141 · 研究领域：Transcranial Magnetic Stimulation Studies、Suicide and Self-Harm Studies、Electroconvulsive Therapy Studies

IMPORTANCE: Magnetic seizure therapy (MST) is a novel therapeutic option for treatment-resistant depression (TRD). Suicidal ideation is often associated with TRD and contributes to the increased mortality and morbidity of the disorder. OBJECTIVE: To identify a biomarker that may serve as an indicator of remission of suicidal ideation following a course of MST by using cortical inhibition measures from interleaved transcranial magnetic stimulation and electroencephalography (TMS-EEG). DESIGN, SETTING, AND PARTICIPANTS: Thirty-three patients with TRD were part of an open-label clinical trial of MST treatment. Data from 27 patients (82%) were available for analysis in this study. Baseline TMS-EEG measures were assessed within 1 week before the initiation of MST treatment using the TMS-EEG measures of cortical inhibition (ie, N100 and long-interval cortical inhibition [LICI]) from the left dorsolateral prefrontal cortex and the left motor cortex, with the latter acting as a control site. INTERVENTIONS: The MST treatments were administered under general anesthesia, and a stimulator coil consisting of 2 individual cone-shaped coils was used. MAIN OUTCOMES AND MEASURES: Suicidal ideation was evaluated before initiation and after completion of MST using the Scale for Suicide Ideation (SSI). Measures of cortical inhibition (ie, N100 and LICI) from the left dorsolateral prefrontal cortex were selected. N100 was quantified as the amplitude of the negative peak around 100 milliseconds in...