BackgroundCognitive impairments are prevalent in patients with unipolar and bipolar depressive disorder. Considering the fact assessing cognitive functions is increasingly feasible for clinicians and researchers, targeting these problems in treatment and using them at baseline as predictors of response to treatment can be very informative.MethodIn a naturalistic, retrospective study, data from 120 patients with UDD and BDD were analyzed. Patients received 20 sessions of bilateral rTMS and were assessed regarding their depressive symptoms, sustained attention, working memory, and executive functions, using (...) the Beck Depression Inventory and Neuropsychological Test Automated Battery Cambridge, at baseline and after the end of rTMS treatment course. Generalized estimating equations and logistic regression were used as the main statistical methods to test the hypotheses.ResultsFifty-three percentage of all patients responded to treatment. In particular, 53.1% of UDD patients and 46.9% of BDD patients responded to treatment. Bilateral rTMS improved all cognitive functions except for visual memory and resulted in more modulations in the working memory of UDD compared to BDD patients. More improvements in working memory were observed in responded patients and visual memory, age, and sex were determined as treatment response predictors. Working memory, visual memory, and age were identified as treatment response predictors in BDD and UDD patients, respectively.ConclusionBilateral rTMS improved cold cognition and depressive symptoms in UDD and BDD patients, possibly by altering cognitive control mechanisms, and processing negative emotional bias. (shrink)