Krstić, Jelena (57188740488)Jelena (57188740488)KrstićBuzadžić, Ivana (38661047900)Ivana (38661047900)BuzadžićMilanović, Slad'an D (57196715895)Slad'an D (57196715895)MilanovićIlić, Nela V. (37861227000)Nela V. (37861227000)IlićPajić, Sanja (55145266700)Sanja (55145266700)PajićIlić, Tihomir V. (18335000500)Tihomir V. (18335000500)Ilić2025-07-022025-07-022014https://doi.org/10.1097/YCT.0000000000000099https://www.scopus.com/inward/record.uri?eid=2-s2.0-84928278612&doi=10.1097%2fYCT.0000000000000099&partnerID=40&md5=e2bdc7e8f42d526982d71fb2ceff9f19https://remedy.med.bg.ac.rs/handle/123456789/13581Introduction: Sham-controlled low-frequency repetitive transcranial magnetic stimulation (rTMS) was used in patients with pharmacoresistant major depressionas anadded treatment along with partial sleep deprivation (PSD). In addition, the potential predictive role of brain-derived neurotrophic factor genetic polymorphism on treatment response was analyzed.; Methods: We recruited 19 female patients (48.3 ± 8.6 years old) with treatment-resistant unipolar major depression (Hamilton Depression Rating Scale [HDRS] score ≥20) who were on a stable antidepressant treatment. They received either 1-Hz rTMS or sham stimulation over the right dorsolateral prefrontal cortex (intensity of 110% of the threshold; 3000 stimuli per protocol; and 10 daily sessions). Additionally, PSD was applied once per week during the treatment. The patients were evaluated (HDRS and Clinical Global Impression Scale) by a blind rater at baseline (B) and after 2 and 3 weeks (W2 and W3) of treatment for short-term outcome. Long-term evaluations were performed after 12 (W12) and 24 weeks (W24) for patients who received active stimulation.; Results: Eleven patients in the active group showed a significant HDRS score reduction from 30.09 ± 3.53 (B) to 16.73 ± 5.71 (W3) compared to the lack of therapeutic response in the sham-treated patients. The long-term follow-up for the active group included 64% of the responders at W12 and 55% at W24. Full remission (HDRS ≤10) was achieved in 5 of 11 patients. Four of these 5 patients with long-term sustained remission expressed the Val66Val genotype.; Conclusion: Our study suggests a clinically relevant response, persisting for up to 6 months, from 1-Hz rTMS over the right dorsolateral prefrontal cortex and PSD in patients with pharmacoresistant major depression. The brain-derived neurotrophic factor Val66Val homozygous genotype may be related to a better treatment outcome. Copyright © 2014 by Lippincott Williams & Wilkins.BDNFMajor depressionSleep deprivationTranscranial magnetic stimulation