BACKGROUND Multiple prior treatment failures are associated with reduced rates of remission to subsequent antidepressant treatment, including rTMS. The degree of treatment resistance that is especially predictive of inferior outcome is uncertain. Intermittent theta burst stimulation (iTBS) is a newer form of rTMS where less is known regarding clinical predictors of remission. The THREE-D study demonstrated that iTBS is non-inferior to 10 Hz rTMS for the treatment of depression. OBJECTIVE Determine if the number and type of prior pharmacotherapy trials affect the rate of remission with two types of rTMS. METHOD Compare remission rates based on prior pharmacotherapy using data from the THREE-D trial (NCT01887782). RESULTS No differences in remission rates were noted between the three levels of treatment resistance, however, participants with 3 compared to <3 treatment failures had lower rates of remission: 17.3% versus 29.4% (χ2 4.87; df = 1; p = 0.03). CONCLUSIONS Three or more treatment failures may be associated with lower remission rates with rTMS.

中文翻译：

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先前治疗对间歇性 theta 脉冲与高频重复经颅磁刺激治疗抵抗性抑郁症缓解的影响

背景多次先前治疗失败与后续抗抑郁治疗（包括 rTMS）的缓解率降低有关。尤其可预测较差结果的治疗抵抗程度是不确定的。间歇性 theta 脉冲刺激 (iTBS) 是一种较新的 rTMS 形式，其中关于缓解的临床预测因素知之甚少。THREE-D 研究表明，iTBS 在治疗抑郁症方面不劣于 10 Hz rTMS。目的 确定先前药物治疗试验的数量和类型是否会影响两种 rTMS 的缓解率。方法 使用来自 THREE-D 试验 (NCT01887782) 的数据，比较基于先前药物治疗的缓解率。结果 三种治疗抵抗水平之间的缓解率没有差异，但是，与 <3 次治疗失败相比，3 次治疗失败的参与者的缓解率较低：17.3% 与 29.4%（χ2 4.87；df = 1；p = 0.03）。结论 3 次或更多次治疗失败可能与 rTMS 的较低缓解率有关。