Response Patterns of Depression Symptoms Following Dorsolateral Prefrontal rTMS Treatment
By
Tyler S. Kaster
Xiao Chen
Jonathan Downar
Fidel Vila-Rodriguez
Danielle A. Baribeau
Kevin E. Thorpe
Zafiris J. Daskalakis
Chao-Gan Yan
Daniel M. Blumberger
September 24, 2026
Clinical Scorecard: Response Patterns of Depression Symptoms Following Dorsolateral Prefrontal rTMS Treatment
At a Glance
Category Detail
Condition Treatment-Resistant Depression (TRD) Key Mechanisms Repetitive transcranial magnetic stimulation (rTMS) stimulates the left dorsolateral prefrontal cortex (DLPFC) to address depression symptoms. Target Population Individuals with treatment-resistant depression. Care Setting Multicenter randomized noninferiority trial conducted at Canadian academic centers.
Key Highlights
Remission occurs in 20% to 40% of TRD patients receiving rTMS. Differential changes in symptom clusters: mood, insomnia, and somatic symptoms show greater reductions than anxiety. Depression's heterogeneity complicates treatment response assessment. Group-based multitrajectory modeling (GBMTM) identifies distinct symptom-cluster response trajectories. Magnetic resonance imaging–guided neuronavigation was used for treatment administration. Guideline-Based Recommendations
Diagnosis
Utilize the Hamilton Depression Rating Scale (HDRS) for symptom assessment. Management
Administer rTMS daily for 4 to 6 weeks, adjusting treatment based on symptom profiles. Monitoring & Follow-up
Conduct weekly HDRS-17 assessments to track symptom changes. Risks
Consider the potential for insufficient benefit despite treatment. Patient & Prescribing Data
Participants in a multicenter trial for major depressive disorder.
Treatment includes both conventional high-frequency stimulation and intermittent theta-burst stimulation.
Clinical Best Practices
Employ imaging-guided neuronavigation for precise rTMS targeting. Adapt treatment protocols based on individual symptom clusters. Related Resources & Content
