Journal: Brain Stimulation (2014)
Authors: Stephenson C, Wirecki T, Levy A, Choudhry Z, Duffy W
Background:
The efficacy of deep TMS (dTMS) in depression has been shown in clinical trials. However, few dTMS studies have been conducted in naturalistic settings.
Objective:
To review response rates to dTMS treatment in a real-world clinical practice setting.
Methods:
This study includes eight patients, ages 25 to 57 years (mean=42) receiving dTMS treatment using H-coil technology. Patients (75% male) met DSM-IV criteria for unipolar (n=7) or bipolar (n=1) depression. Patients received acute dTMS five days/week (at least 30 sessions) plus maintenance treatments. Five patients received unilateral and three received bilateral treatments.
Results:
A repeated measures ANOVA comparing baseline to session 20 revealed a significant effect (p=0.000), with a 52 percent decrease in depressive symptoms and 25 percent of patients reporting remission (BDI < 10). After an additional ten acute-phase treatments, 6 of 8 patients reported further gains (a subsequent 26 percent decrease in depressive symptoms), with 50 percent reporting remission. During maintenance, 3 of 8 patients continued to experience a further decrease in depressive symptoms; one patient achieved remission. In the unilateral group, overall remission rate was 66% and response (>50 percent reduction in BDI) rate was 80 percent. In the bilateral group, 66% of patients achieved remission, and 100% responded.
Conclusions:
The majority of improvement occurred during the first 20 treatments; however, extending the acute phase to 30 treatments resulted in clinically significant gains. Response and remission rates were similar in the unilateral and bilateral groups. However, studies with larger sample sizes are required to reach firm conclusions.
Full Publication: Efficacy of Deep TMS for the Treatment of Depression in a Real-world Clinical Practice Setting – ScienceDirect
