INS NYC 2024 Program

Poster	Poster Session 04 Program Schedule 02/15/2024 12:00 pm - 01:15 pm Room: Majestic Complex (Posters 61-120) Poster Session 04: Neuroimaging \| Neurostimulation/Neuromodulation \| Teleneuropsychology/Technology Final Abstract #76 Impact of Alcohol Consumption Before and After Treatment on the Efficacy of rTMS Therapy Jairelisse Morales Morales, Stanford University, Palo Alto, United States Jairelisse Morales Morales, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States Nicole Walker, Stanford University, Palo Alto, United States Nicole Walker, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States Robert Hickson, Palo Alto University, Palo Alto, United States Robert Hickson, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States Lisa Cruz, Stanford University, Palo Alto, United States Lisa Cruz, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States Michelle Madore, Stanford University, Palo Alto, United States Michelle Madore, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States Category: Neurostimulation/Neuromodulation Keyword 1: neurostimulation Keyword 2: depression Keyword 3: alcohol Objective: Major Depressive Disorder (MDD) is currently the most prevalent life-time psychiatric illness and one of the leading causes of disability in developed countries. MDD is highly prevalent in individuals with alcohol use disorder (AUD). This comorbidity increases the complexity and burden of depression diagnosis and might interfere in treatment outcomes. Therapeutic non-invasive neuromodulation treatment such as repetitive transcranial magnetic stimulation (rTMS) has been FDA approved since 2008 and is currently used as an antidepressant treatment for pharmacological resistant patients with MDD. The effects of alcohol consumption on repetitive transcranial magnetic stimulation (rTMS) outcomes for patients with MDD have not been extensively studied. For the current study, it was hypothesized that MDD patients who did not exhibit drinking behavior at baseline treatment would exhibit better outcomes with transcranial magnetic stimulation (TMS) treatment for their depression. Participants and Methods: Participants consisted of 660 Veterans (21.4% female; age M = 52, SD = 13.9) who completed a full 30-session course of TMS treatment and had alcoholic drinks before pre and post treatment. Participants were given Patient Health Questionnaire (PHQ-9) at baseline and again after completion of TMS treatment. An independent samples t-test comparing Veterans who reported drinking alcohol to those who did not drink alcohol on their post-treatment PHQ-9 was used to test our hypothesis. Results: There was no significant difference between Veterans who reported drinking alcohol versus those who did not on the PHQ-9 following TMS treatment t(1148) = 0.883, p= .843). Post-hoc analysis revealed that there was a significant different at the pre-treatment time point on the PHQ-9 between the groups. Of note, those who reported not consuming alcohol reported increased depressive symptoms compared to those who did t(1689) = 2.171, p= .035). Conclusions: Alcohol use before treatment did not have an impact on TMS outcomes. Surprisingly, individuals who reported they did not drink alcohol at the pre-treatment timepoint had slightly worse depressive symptoms. This may be related to a “self-medication” effect of alcohol use in those individuals. It is also important to note that severe alcohol use disorder is exclusionary for TMS treatment due to increased risk of seizure disorder. It may be that those who used more may demonstrate this effect. Considering these findings, the current research sets the stage for future explorations focusing on the co-occurrence of psychiatric disorders among individuals undergoing rTMS treatment. The observed relationship between alcohol consumption and treatment outcomes underscores the potential influence of psychiatric comorbidities on both alcohol use behavior and response to rTMS therapy.

Poster

02/15/2024
12:00 pm - 01:15 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology

Final Abstract #76

Impact of Alcohol Consumption Before and After Treatment on the Efficacy of rTMS Therapy

Jairelisse Morales Morales, Stanford University, Palo Alto, United States
Jairelisse Morales Morales, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States
Nicole Walker, Stanford University, Palo Alto, United States
Nicole Walker, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States
Robert Hickson, Palo Alto University, Palo Alto, United States
Robert Hickson, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States
Lisa Cruz, Stanford University, Palo Alto, United States
Lisa Cruz, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States
Michelle Madore, Stanford University, Palo Alto, United States
Michelle Madore, Mental Illness Research, Education, and Clinical Center VA Palo Alto Health Care System, Palo Alto, United States

Category: Neurostimulation/Neuromodulation

Keyword 1: neurostimulation
Keyword 2: depression
Keyword 3: alcohol

Objective:

Major Depressive Disorder (MDD) is currently the most prevalent life-time psychiatric illness and one of the leading causes of disability in developed countries. MDD is highly prevalent in individuals with alcohol use disorder (AUD). This comorbidity increases the complexity and burden of depression diagnosis and might interfere in treatment outcomes. Therapeutic non-invasive neuromodulation treatment such as repetitive transcranial magnetic stimulation (rTMS) has been FDA approved since 2008 and is currently used as an antidepressant treatment for pharmacological resistant patients with MDD. The effects of alcohol consumption on repetitive transcranial magnetic stimulation (rTMS) outcomes for patients with MDD have not been extensively studied. For the current study, it was hypothesized that MDD patients who did not exhibit drinking behavior at baseline treatment would exhibit better outcomes with transcranial magnetic stimulation (TMS) treatment for their depression.

Participants and Methods:

Participants consisted of 660 Veterans (21.4% female; age M = 52, SD = 13.9) who completed a full 30-session course of TMS treatment and had alcoholic drinks before pre and post treatment. Participants were given Patient Health Questionnaire (PHQ-9) at baseline and again after completion of TMS treatment. An independent samples t-test comparing Veterans who reported drinking alcohol to those who did not drink alcohol on their post-treatment PHQ-9 was used to test our hypothesis.

Results:

There was no significant difference between Veterans who reported drinking alcohol versus those who did not on the PHQ-9 following TMS treatment t(1148) = 0.883, p= .843). Post-hoc analysis revealed that there was a significant different at the pre-treatment time point on the PHQ-9 between the groups. Of note, those who reported not consuming alcohol reported increased depressive symptoms compared to those who did t(1689) = 2.171, p= .035).

Conclusions:

Alcohol use before treatment did not have an impact on TMS outcomes. Surprisingly, individuals who reported they did not drink alcohol at the pre-treatment timepoint had slightly worse depressive symptoms. This may be related to a “self-medication” effect of alcohol use in those individuals. It is also important to note that severe alcohol use disorder is exclusionary for TMS treatment due to increased risk of seizure disorder. It may be that those who used more may demonstrate this effect.

Considering these findings, the current research sets the stage for future explorations focusing on the co-occurrence of psychiatric disorders among individuals undergoing rTMS treatment. The observed relationship between alcohol consumption and treatment outcomes underscores the potential influence of psychiatric comorbidities on both alcohol use behavior and response to rTMS therapy.