Investigation of physical activity, sleep, and mental health recovery in treatment resistant depression (TRD) patients receiving repetitive transcranial magnetic stimulation (rTMS) treatment

Chris Griffiths, Ksenija Maravic da Silva, Chloe Leathlean, Harmony Jiang, Chee Siang Ang, Ryan Searle

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)
    164 Downloads (Pure)

    Abstract

    Background
    Repetitive transcranial magnetic stimulation (rTMS) is effective in treating depression; however, the effect on physical activity, sleep and recovery is unclear. This study investigated rTMS effect on physical activity and sleep through providing patients with a Fitbit and software apps; and reports the impact of rTMS on depression, anxiety and mental health recovery.

    Methods
    Study design was a pre and post data collection without a control, with twenty-four participants with treatment-resistant depression (TRD). Measures used were Fitbit activity and sleep data, and patient-rated Recovering Quality of Life (ReQoL-20), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder (GAD-7).

    Results
    Response and remission rates were, respectively: 34.8% and 39% for PHQ-9; 34.8% and 47.8% for GAD-7. ReQoL-20 response and reliable improvement were 29.4% and 53%. PHQ-9, GAD-7 and ReQol-20 scores significantly improved, with large effect sizes. Analysis of Fitbit activity and sleep data yielded non-significant results. The Fitbit data machine learning model classified two levels of depression to 82% accuracy.

    Limitations
    rTMS treatment was open-label and adjunct to existing antidepressant medication. No control group. Female patients were overrepresented.

    Conclusions
    Improvements on the ReQoL-20 and aspects of sleep and activity indicate the positive impact of rTMS on the individual's real world functioning and quality of life. A wearable activity tracker can provide feedback to patients and clinicians on sleep, physical activity and depression levels. Further research could be undertaken through a sufficiently powered RCT comparing rTMS versus rTMS with use of a Fitbit, its software applications, and sleep and physical activity advice.
    Original languageEnglish
    Article number100337
    Number of pages10
    JournalJournal of Affective Disorders Reports
    Volume8
    Early online date17 Mar 2022
    DOIs
    Publication statusPublished - Apr 2022

    Bibliographical note

    © 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).

    Keywords

    • Activity
    • Depression
    • Exercise
    • Fitbit
    • Recovery
    • Sleep
    • rTMS

    ASJC Scopus subject areas

    • Psychiatry and Mental health
    • Clinical Psychology

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