The Role of Sex and Age in rTMS Efficacy for Treating Major Depressive Disorder

Transcranial Magnetic Stimulation (rTMS) has become an established, FDA-approved non-invasive treatment for Major Depressive Disorder (MDD), particularly for individuals who have not responded to traditional treatments like antidepressants. However, recent studies highlight that factors like biological sex and age can influence the effectiveness of different rTMS protocols, offering crucial insights into personalized treatment approaches.

Key Findings from the Study:

A large-scale retrospective analysis involving 414 patients explored how two commonly used rTMS protocols—10 Hz and intermittent Theta Burst Stimulation (iTBS)—differ in efficacy based on sex and age. Here’s what the study found:

1. Sex Differences:

   • Females responded more favorably to the 10 Hz protocol, showing greater improvement compared to iTBS.

   • Males, on the other hand, showed better results with iTBS than with 10 Hz.

   • These differences were noticeable by the 10th treatment and became more pronounced by the 30th session.

2. Age Factor:

   • Patients aged 50 and older responded better to rTMS overall, with females in this age group showing particularly significant improvements, regardless of the protocol used.

   • This is consistent with earlier findings suggesting that older individuals, especially postmenopausal females, tend to have different responses to both medication and non-invasive treatments for depression.

Implications for rTMS Treatment:

The findings underscore the importance of tailoring rTMS treatment protocols based on individual patient factors like sex and age. Women over 50, in particular, may benefit more from 10 Hz stimulation, while younger men may respond better to iTBS.

This personalized approach is essential for maximizing the efficacy of rTMS and improving patient outcomes in treating MDD, especially given the complexities of treatment-resistant depression.

Conclusion:

As rTMS continues to evolve as a critical tool in the treatment of depression, studies like this shed light on the nuanced factors that contribute to its success. Clinicians may increasingly rely on patient-specific variables such as sex and age to guide the selection of rTMS protocols, ensuring more effective and targeted treatment strategies.

This research is a significant step forward in understanding how to optimize rTMS for diverse patient populations, offering hope for more refined and successful treatment outcomes.