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Title: A pilot investigation of an intensive theta burst stimulation protocol for patients with treatment resistant depression.
Epworth Authors: Fitzgerald, Paul
Other Authors: Chen, Leo
Richardson, Karyn
Daskalakis, Zafiris
Hoy, Kate
Keywords: rTMS
Repetitive Transcranial Magnetic Stimulation
Major Depressive Disorder
Theta Burst Stimulation
Patient Assessment
Depressive Symptoms
Response Rates
Epworth Centre for Innovation in Mental Health, The Epworth Clinic, Camberwell, Victoria, Australia.
Rehabilitation, Mental Health and Chronic Pain Clinical Institute, Epworth HealthCare, Victoria, Australia.
Issue Date: Aug-2019
Publisher: Elsevier
Citation: Brain Stimul. 2019 Aug 22. pii: S1935-861X(19)30359-6
Abstract: INTRODUCTION: Accelerated or intensive forms of repetitive transcranial magnetic stimulation (rTMS) are increasingly being explored for their potential to produce more efficient and rapid treatment benefits in major depressive disorder (MDD). However, accelerated or intensive protocols using standard forms of rTMS are still quite time-consuming to apply. Theta burst stimulation (TBS) is a novel form of magnetic stimulation with the potential to produce similar anti-depressant effects but in a much abbreviated period of time. The aim of this study was to investigate the comparative efficacy of an intensive TBS protocol compared to standard rTMS treatment. METHODS: 74 outpatients (36 female, mean age 44.36 ± 12.1 years) with MDD received either intensive TBS (3 intermittent TBS treatments per day for 3 days in week 1, 3 treatments a day for 2 days in week 2, and 3 treatments in 1 day in week 3 and in week 4, or standard rTMS (5 daily sessions per week for 4 weeks). Patients were assessed weekly throughout the treatment course, and at 4 weeks after treatment end. RESULTS: There were no significant differences in the degree of reduction in depressive symptoms, the rate of reduction in depressive symptoms, remission or response rates (response rates = 27.8% for intensive group, 26.3% for the standard group, p > 0.05 for all analyses) between the intensive TBS and standard rTMS treatment groups. However, the overall response and remission rates were limited in both groups. There was no difference in rates of side effects, no serious adverse events and no alterations in cognitive performance. CONCLUSION: Intensively applied TBS appears to have similar efficacy to standard rTMS when these were applied as delivered in this study but does not produce more rapid clinical benefits. The overall response rates in both groups in this study were limited, most likely by the total doses provided in both study arms.
DOI: 10.1016/j.brs.2019.08.013
PubMed URL:
ISSN: 1935-861X
Journal Title: Brain Stimulation
Type: Journal Article
Affiliated Organisations: Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Victoria, Australia
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Ontario, Canada
Type of Clinical Study or Trial: Pilot Study
Appears in Collections:Mental Health

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