Factors for predicting response to electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and ketamine in patients with treatment-resistant depression: a systematic review.
International journal of psychiatry in clinical practice February 7, 2026 Daniel Pustay, Vishal Patel, Krista Ulisse et al.
A systematic review of 42 studies examined predictors of response to electroconvulsive therapy, repetitive transcranial magnetic stimulation, and ketamine-based treatments in adults with treatment-resistant depression. Predictive factors were grouped into clinical (symptom profile, illness duration), biological (IL-6, CRP, BDNF), and imaging (cingulate cortex activity, connectivity) categories. Inflammation markers and fronto-limbic network findings appeared across treatments but were inconsistent. Some predictors show promise, but clinical use remains limited by methodological differences and small sample sizes. Larger and comparative studies are needed to identify clinically useful predictors for treatment decision-making.