Improvement in hypersomnia with high frequency repetitive transcranial magnetic stimulation in depressed adolescents: Preliminary evidence from an open-label study
Sleep disruption is a significant symptom of major depressive disorder (MDD). To our knowledge, no prior work has examined the impact of repetitive transcranial magnetic stimulation (rTMS) on sleep disturbances in adolescents with MDD. Seventeen adolescents with treatment-resistant depression receiv...
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| creator | Sonmez, A. Irem Kucuker, M. Utku Lewis, Charles P. Kolla, Bhanu Prakash Doruk Camsari, Deniz Vande Voort, Jennifer L. Schak, Kathryn M. Kung, Simon Croarkin, Paul E. |
| description | Sleep disruption is a significant symptom of major depressive disorder (MDD). To our knowledge, no prior work has examined the impact of repetitive transcranial magnetic stimulation (rTMS) on sleep disturbances in adolescents with MDD.
Seventeen adolescents with treatment-resistant depression received 30 daily sessions of 10-Hz rTMS applied to the left dorsolateral prefrontal cortex (L-DLPFC). Clinical symptoms were assessed at baseline; after 10, 20, and 30 treatments; and at a 6-month follow-up visit. Insomnia was measured with a 3-item subscale of the Quick Inventory of Depressive Symptomatology–Adolescent (17 Item)–Self Report (QIDS-A17-SR). Hypersomnia was measured with a single QIDS-A17-SR item. Depression severity was rated with the Children's Depression Rating Scale, Revised (CDRS-R). The effect of rTMS on sleep was examined via linear mixed model analyses, with fixed effects of time (as a proxy of treatment), depression severity, age, and hypnotic medication use.
No significant main effect of time was observed on the insomnia subscale (F4,43.442 = 1.078, p = 0 .379). However, there was a significant main effect of time on the QIDS-A17-SR hypersomnia score (F4,46.124 = 2.733, p = 0 .040), with significant improvement from baseline to treatment 10 (padj = 0.019) and from baseline to 6-month follow-up (padj = 0.044). In exploratory sensitivity analyses, response/nonresponse to rTMS for overall depressive symptoms had no significant effect on sleep outcomes.
rTMS may have intrinsic effects on hypersomnia apart from its antidepressant effects in depressed adolescents. Future work should utilize sham controls and objective, quantitative measurements of sleep architecture to assess effects of rTMS in depressed adolescents.
Clinicaltrials.gov identifiers are NCT00587639, NCT01502033, NCT01804270.
•Sleep disturbance is a common symptom in adolescents with depression. This open-label study examined the impact of rTMS on insomnia and hypersomnia.•This pilot study found that rTMS resulted in an improvement in hypersomnia in a sample of adolescents with treatment-resistant depression. |
| doi_str_mv | 10.1016/j.pnpbp.2019.109763 |
| format | Article |
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Seventeen adolescents with treatment-resistant depression received 30 daily sessions of 10-Hz rTMS applied to the left dorsolateral prefrontal cortex (L-DLPFC). Clinical symptoms were assessed at baseline; after 10, 20, and 30 treatments; and at a 6-month follow-up visit. Insomnia was measured with a 3-item subscale of the Quick Inventory of Depressive Symptomatology–Adolescent (17 Item)–Self Report (QIDS-A17-SR). Hypersomnia was measured with a single QIDS-A17-SR item. Depression severity was rated with the Children's Depression Rating Scale, Revised (CDRS-R). The effect of rTMS on sleep was examined via linear mixed model analyses, with fixed effects of time (as a proxy of treatment), depression severity, age, and hypnotic medication use.
No significant main effect of time was observed on the insomnia subscale (F4,43.442 = 1.078, p = 0 .379). However, there was a significant main effect of time on the QIDS-A17-SR hypersomnia score (F4,46.124 = 2.733, p = 0 .040), with significant improvement from baseline to treatment 10 (padj = 0.019) and from baseline to 6-month follow-up (padj = 0.044). In exploratory sensitivity analyses, response/nonresponse to rTMS for overall depressive symptoms had no significant effect on sleep outcomes.
rTMS may have intrinsic effects on hypersomnia apart from its antidepressant effects in depressed adolescents. Future work should utilize sham controls and objective, quantitative measurements of sleep architecture to assess effects of rTMS in depressed adolescents.
Clinicaltrials.gov identifiers are NCT00587639, NCT01502033, NCT01804270.
•Sleep disturbance is a common symptom in adolescents with depression. This open-label study examined the impact of rTMS on insomnia and hypersomnia.•This pilot study found that rTMS resulted in an improvement in hypersomnia in a sample of adolescents with treatment-resistant depression.</description><identifier>ISSN: 0278-5846</identifier><identifier>EISSN: 1878-4216</identifier><identifier>DOI: 10.1016/j.pnpbp.2019.109763</identifier><identifier>PMID: 31634515</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Adolescent ; Depression ; Depressive Disorder, Major - therapy ; Depressive Disorder, Treatment-Resistant - complications ; Depressive Disorder, Treatment-Resistant - therapy ; Disorders of Excessive Somnolence - complications ; Disorders of Excessive Somnolence - therapy ; Female ; Humans ; Hypersomnia ; Insomnia ; Male ; Pilot Projects ; Prefrontal Cortex - physiology ; Repetitive transcranial magnetic stimulation (rTMS) ; Sleep Initiation and Maintenance Disorders - complications ; Sleep Initiation and Maintenance Disorders - therapy ; Transcranial Magnetic Stimulation - methods ; Young Adult</subject><ispartof>Progress in neuro-psychopharmacology & biological psychiatry, 2020-03, Vol.97, p.109763-109763, Article 109763</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-31aebf95c3a9c8a698640e586db4608bf58001d9762e90d86857ba3d6db262993</citedby><cites>FETCH-LOGICAL-c459t-31aebf95c3a9c8a698640e586db4608bf58001d9762e90d86857ba3d6db262993</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0278584619305500$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31634515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sonmez, A. Irem</creatorcontrib><creatorcontrib>Kucuker, M. Utku</creatorcontrib><creatorcontrib>Lewis, Charles P.</creatorcontrib><creatorcontrib>Kolla, Bhanu Prakash</creatorcontrib><creatorcontrib>Doruk Camsari, Deniz</creatorcontrib><creatorcontrib>Vande Voort, Jennifer L.</creatorcontrib><creatorcontrib>Schak, Kathryn M.</creatorcontrib><creatorcontrib>Kung, Simon</creatorcontrib><creatorcontrib>Croarkin, Paul E.</creatorcontrib><title>Improvement in hypersomnia with high frequency repetitive transcranial magnetic stimulation in depressed adolescents: Preliminary evidence from an open-label study</title><title>Progress in neuro-psychopharmacology & biological psychiatry</title><addtitle>Prog Neuropsychopharmacol Biol Psychiatry</addtitle><description>Sleep disruption is a significant symptom of major depressive disorder (MDD). To our knowledge, no prior work has examined the impact of repetitive transcranial magnetic stimulation (rTMS) on sleep disturbances in adolescents with MDD.
Seventeen adolescents with treatment-resistant depression received 30 daily sessions of 10-Hz rTMS applied to the left dorsolateral prefrontal cortex (L-DLPFC). Clinical symptoms were assessed at baseline; after 10, 20, and 30 treatments; and at a 6-month follow-up visit. Insomnia was measured with a 3-item subscale of the Quick Inventory of Depressive Symptomatology–Adolescent (17 Item)–Self Report (QIDS-A17-SR). Hypersomnia was measured with a single QIDS-A17-SR item. Depression severity was rated with the Children's Depression Rating Scale, Revised (CDRS-R). The effect of rTMS on sleep was examined via linear mixed model analyses, with fixed effects of time (as a proxy of treatment), depression severity, age, and hypnotic medication use.
No significant main effect of time was observed on the insomnia subscale (F4,43.442 = 1.078, p = 0 .379). However, there was a significant main effect of time on the QIDS-A17-SR hypersomnia score (F4,46.124 = 2.733, p = 0 .040), with significant improvement from baseline to treatment 10 (padj = 0.019) and from baseline to 6-month follow-up (padj = 0.044). In exploratory sensitivity analyses, response/nonresponse to rTMS for overall depressive symptoms had no significant effect on sleep outcomes.
rTMS may have intrinsic effects on hypersomnia apart from its antidepressant effects in depressed adolescents. Future work should utilize sham controls and objective, quantitative measurements of sleep architecture to assess effects of rTMS in depressed adolescents.
Clinicaltrials.gov identifiers are NCT00587639, NCT01502033, NCT01804270.
•Sleep disturbance is a common symptom in adolescents with depression. This open-label study examined the impact of rTMS on insomnia and hypersomnia.•This pilot study found that rTMS resulted in an improvement in hypersomnia in a sample of adolescents with treatment-resistant depression.</description><subject>Adolescent</subject><subject>Depression</subject><subject>Depressive Disorder, Major - therapy</subject><subject>Depressive Disorder, Treatment-Resistant - complications</subject><subject>Depressive Disorder, Treatment-Resistant - therapy</subject><subject>Disorders of Excessive Somnolence - complications</subject><subject>Disorders of Excessive Somnolence - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Hypersomnia</subject><subject>Insomnia</subject><subject>Male</subject><subject>Pilot Projects</subject><subject>Prefrontal Cortex - physiology</subject><subject>Repetitive transcranial magnetic stimulation (rTMS)</subject><subject>Sleep Initiation and Maintenance Disorders - complications</subject><subject>Sleep Initiation and Maintenance Disorders - therapy</subject><subject>Transcranial Magnetic Stimulation - methods</subject><subject>Young Adult</subject><issn>0278-5846</issn><issn>1878-4216</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU2L1TAULaI4b0Z_gSBZuukzado0ERRk0HFgQBe6Dmlz-5pHPmrSVt7v8Y-a-sZBN26ScO-559ycUxQvCN4TTNjr437yUzftK0xEroiW0UfFjvCWl3VF2ONih6v8bnjNLorLlI4YY0IxfVpcUMJo3ZBmV_y8dVMMKzjwMzIejacJYgrOG4V-mHlEozmMaIjwfQHfn1CECWYzmxXQHJVPfT6Mssipg8-NHqXZuMWq2QS_8WmYIqQEGikdLKQ-66Q36EsEa5zxKp4QrEZnbsgqwSHlUZjAl1Z1YDPbok_PiieDsgme399XxbePH75efyrvPt_cXr-_K_u6EXNJiYJuEE1Plei5YoKzGkPDme5qhnk3NDwboLNPFQisOeNN2ymqc79ilRD0qnh35p2WzoHeVo3Kyikal_eUQRn5b8ebUR7CKpnAtah5Jnh1TxBD9ivN0pn8Y2uVh7AkWVHctpSQmmQoPUP7GFKKMDzIECy3eOVR_o5XbvHKc7x56uXfGz7M_MkzA96eAZB9Wg1EmXqzmatNhH6WOpj_CvwCqAu9vA</recordid><startdate>20200308</startdate><enddate>20200308</enddate><creator>Sonmez, A. Irem</creator><creator>Kucuker, M. Utku</creator><creator>Lewis, Charles P.</creator><creator>Kolla, Bhanu Prakash</creator><creator>Doruk Camsari, Deniz</creator><creator>Vande Voort, Jennifer L.</creator><creator>Schak, Kathryn M.</creator><creator>Kung, Simon</creator><creator>Croarkin, Paul E.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200308</creationdate><title>Improvement in hypersomnia with high frequency repetitive transcranial magnetic stimulation in depressed adolescents: Preliminary evidence from an open-label study</title><author>Sonmez, A. Irem ; Kucuker, M. Utku ; Lewis, Charles P. ; Kolla, Bhanu Prakash ; Doruk Camsari, Deniz ; Vande Voort, Jennifer L. ; Schak, Kathryn M. ; Kung, Simon ; Croarkin, Paul E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-31aebf95c3a9c8a698640e586db4608bf58001d9762e90d86857ba3d6db262993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Depression</topic><topic>Depressive Disorder, Major - therapy</topic><topic>Depressive Disorder, Treatment-Resistant - complications</topic><topic>Depressive Disorder, Treatment-Resistant - therapy</topic><topic>Disorders of Excessive Somnolence - complications</topic><topic>Disorders of Excessive Somnolence - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Hypersomnia</topic><topic>Insomnia</topic><topic>Male</topic><topic>Pilot Projects</topic><topic>Prefrontal Cortex - physiology</topic><topic>Repetitive transcranial magnetic stimulation (rTMS)</topic><topic>Sleep Initiation and Maintenance Disorders - complications</topic><topic>Sleep Initiation and Maintenance Disorders - therapy</topic><topic>Transcranial Magnetic Stimulation - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sonmez, A. Irem</creatorcontrib><creatorcontrib>Kucuker, M. Utku</creatorcontrib><creatorcontrib>Lewis, Charles P.</creatorcontrib><creatorcontrib>Kolla, Bhanu Prakash</creatorcontrib><creatorcontrib>Doruk Camsari, Deniz</creatorcontrib><creatorcontrib>Vande Voort, Jennifer L.</creatorcontrib><creatorcontrib>Schak, Kathryn M.</creatorcontrib><creatorcontrib>Kung, Simon</creatorcontrib><creatorcontrib>Croarkin, Paul E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Progress in neuro-psychopharmacology & biological psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sonmez, A. Irem</au><au>Kucuker, M. Utku</au><au>Lewis, Charles P.</au><au>Kolla, Bhanu Prakash</au><au>Doruk Camsari, Deniz</au><au>Vande Voort, Jennifer L.</au><au>Schak, Kathryn M.</au><au>Kung, Simon</au><au>Croarkin, Paul E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improvement in hypersomnia with high frequency repetitive transcranial magnetic stimulation in depressed adolescents: Preliminary evidence from an open-label study</atitle><jtitle>Progress in neuro-psychopharmacology & biological psychiatry</jtitle><addtitle>Prog Neuropsychopharmacol Biol Psychiatry</addtitle><date>2020-03-08</date><risdate>2020</risdate><volume>97</volume><spage>109763</spage><epage>109763</epage><pages>109763-109763</pages><artnum>109763</artnum><issn>0278-5846</issn><eissn>1878-4216</eissn><abstract>Sleep disruption is a significant symptom of major depressive disorder (MDD). To our knowledge, no prior work has examined the impact of repetitive transcranial magnetic stimulation (rTMS) on sleep disturbances in adolescents with MDD.
Seventeen adolescents with treatment-resistant depression received 30 daily sessions of 10-Hz rTMS applied to the left dorsolateral prefrontal cortex (L-DLPFC). Clinical symptoms were assessed at baseline; after 10, 20, and 30 treatments; and at a 6-month follow-up visit. Insomnia was measured with a 3-item subscale of the Quick Inventory of Depressive Symptomatology–Adolescent (17 Item)–Self Report (QIDS-A17-SR). Hypersomnia was measured with a single QIDS-A17-SR item. Depression severity was rated with the Children's Depression Rating Scale, Revised (CDRS-R). The effect of rTMS on sleep was examined via linear mixed model analyses, with fixed effects of time (as a proxy of treatment), depression severity, age, and hypnotic medication use.
No significant main effect of time was observed on the insomnia subscale (F4,43.442 = 1.078, p = 0 .379). However, there was a significant main effect of time on the QIDS-A17-SR hypersomnia score (F4,46.124 = 2.733, p = 0 .040), with significant improvement from baseline to treatment 10 (padj = 0.019) and from baseline to 6-month follow-up (padj = 0.044). In exploratory sensitivity analyses, response/nonresponse to rTMS for overall depressive symptoms had no significant effect on sleep outcomes.
rTMS may have intrinsic effects on hypersomnia apart from its antidepressant effects in depressed adolescents. Future work should utilize sham controls and objective, quantitative measurements of sleep architecture to assess effects of rTMS in depressed adolescents.
Clinicaltrials.gov identifiers are NCT00587639, NCT01502033, NCT01804270.
•Sleep disturbance is a common symptom in adolescents with depression. This open-label study examined the impact of rTMS on insomnia and hypersomnia.•This pilot study found that rTMS resulted in an improvement in hypersomnia in a sample of adolescents with treatment-resistant depression.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>31634515</pmid><doi>10.1016/j.pnpbp.2019.109763</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Depression Depressive Disorder, Major - therapy Depressive Disorder, Treatment-Resistant - complications Depressive Disorder, Treatment-Resistant - therapy Disorders of Excessive Somnolence - complications Disorders of Excessive Somnolence - therapy Female Humans Hypersomnia Insomnia Male Pilot Projects Prefrontal Cortex - physiology Repetitive transcranial magnetic stimulation (rTMS) Sleep Initiation and Maintenance Disorders - complications Sleep Initiation and Maintenance Disorders - therapy Transcranial Magnetic Stimulation - methods Young Adult |
| title | Improvement in hypersomnia with high frequency repetitive transcranial magnetic stimulation in depressed adolescents: Preliminary evidence from an open-label study |
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