A pilot investigation of an intensive theta burst stimulation protocol for patients with treatment resistant depression

Autor: Leo Chen, Karyn E. Richardson, Zafiris J. Daskalakis, Paul B. Fitzgerald, Kate E. Hoy
Rok vydání: 2019
Předmět:
Adult
Male
Remission
Repetitive transcranial magnetic stimulation
medicine.medical_treatment
Biophysics
Antidepressant
Prefrontal cortex
050105 experimental psychology
lcsh:RC321-571
Treatment and control groups
03 medical and health sciences
Depressive Disorder
Treatment-Resistant
0302 clinical medicine
Medicine
Humans
0501 psychology and cognitive sciences
Effects of sleep deprivation on cognitive performance
Theta Rhythm
Adverse effect
lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry
Depression (differential diagnoses)
Depression
business.industry
General Neuroscience
05 social sciences
Response
Middle Aged
medicine.disease
Transcranial Magnetic Stimulation
3. Good health
Clinical trial
Transcranial magnetic stimulation
Anesthesia
Major depressive disorder
Female
Neurology (clinical)
business
Treatment-resistant depression
030217 neurology & neurosurgery
Zdroj: Brain Stimulation, Vol 13, Iss 1, Pp 137-144 (2020)
ISSN: 1876-4754
Popis: 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. Clinical trials registration Australian New Zealand Clinical Trials Registry: ACTRN12616000443493.
Databáze: OpenAIRE
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