Somatization as a Negative Predictor of TMS Treatment Response

subgenual cingulate cortex.A highly accelerated iTBS protocol (50 sessions over 5 days with 50-minute intervals) was employed at 90% of the depth-corrected resting motor threshold.The primary endpoint was response rate measured by the Montgomery-sberg Depression Rating Scale (MADRS) at the end of treatment.Assessments were conducted at baseline, immediately after treatment, and at 1-and 3-month follow-ups.Results: Twenty-one patients were recruited, and 20 completed treatment (57.1% female, mean age 35.1 years SD 12.3).Comorbidities included generalized anxiety disorder (60%), post-traumatic stress disorder (30%), and personality disorders (30%), among others.The immediate post-treatment response and remission rates were 65% and 30%, respectively.MADRS scores improved from 28.1 (SD 5.1) at baseline to 12.1 (SD 5.6) post-treatment, with scores of 18.5 (SD 10.7) and 20.4 (SD 6.6) at 1-and 3-month follow-ups, respectively.Discussion: This functional connectivity-guided iTBS protocol with a Singaporean targeting algorithm was effective in a naturalistic, highly comorbid Asian TRD population, demonstrating reasonable durability up to 3 months.