Journal of Affective Disorders Reports · Published 2026-07-01 · DOI 10.1016/j.jadr.2026.101122
Jhen-Wu Lai, Chih-Ming Cheng, Jia-Shyun Jeng, Kuan-I Liu, Cheng-Ta Li
Background: Non-invasive brain stimulation (NIBS) shows efficacy in major depressive disorder (MDD), but its effectiveness across bipolar disorder (BD) subtypes remains unclear. Methods: This real-world retrospective study reviewed medical records of patients with MDD (n = 120) and BD (n = 20) who received NIBS (10-Hz rTMS, bilateral rTMS, or prolonged iTBS). Clinical effectiveness was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17). Results: Overall antidepressant efficacy was comparable between MDD and BD (36.5%vs. 48.5% HDRS-17 reduction, p = 0.161), despite greater treatment resistance and higher resting motor thresholds in BD. In an exploratory subgroup analysis, BD-I patients showed greater HDRS-17 reduction than BD-II patients (68.1%vs. 33.6%; p = 0.004; Hedges' g = 1.73), with higher response rates (66.7%vs. 0%; Fisher’s exact p = 0.002) and remission rates (55.6%vs. 9.1%; Fisher’s exact p = 0.050). The p-values for HDRS-17 percentage reduction and post-treatment HDRS-17 score were both below the Bonferroni-corrected threshold. The subtype difference remained significant after adjusting for age, sex, and baseline HDRS-17 (F = 14.40, p = 0.003, partial η² = 0.567). Side effect profiles were similar between groups. Conclusions: BD-I patients showed a larger preliminary antidepressant response to NIBS than BD-II patients. These hypothesis-generating findings require validation in larger, prospective, controlled studies.
Abstract from DOAJ. Public domain (CC0 1.0).
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Lai, J., Cheng, C., Jeng, J., et al. (2026). Subtype-specific antidepressant effects of non-invasive brain stimulation in bipolar I and II depression: A real-world preliminary comparative study. Journal of Affective Disorders Reports. https://doi.org/10.1016/j.jadr.2026.101122