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Brain Stimul. 2017 Jul - Aug;10(4):847-849. doi: 10.1016/j.brs.2017.02.013. Epub 2017 Mar 10.

61% of unmedicated treatment resistant depression patients who did not respond to acute TMS treatment responded after four weeks of twice weekly deep TMS in the Brainsway pivotal trial.

Author information

1
Butler Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, United States. Electronic address: agustinyip@brown.edu.
2
Ralph H Johnson VA Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
3
Brainsway Ltd, Jerusalem, Israel.
4
The Zlotoesky Neuroscience Center, Ben-Gurion University, Beer Shava, Israel.
5
Butler Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, United States.

Abstract

BACKGROUND:

An acute course of dTMS typically involves treatments delivered 5 days a week, for 4 weeks. Should more treatments be given if the patient has not responded? Data are needed to inform decisions about the best next steps for acute non-responders.

OBJECTIVE:

To characterize response among acute-phase non-responders in a randomized controlled trial of deep repetitive transcranial magnetic stimulation (dTMS) monotherapy for medication-resistant depression.

METHODS:

Summary statistics and Kaplan-Meier curves were used to characterize outcomes of 33 medication-free Brainsway™ dTMS non-responders to double blind but active treatment at the end of 4 weeks (20 sessions), who then continued double blind but active twice-weekly treatment for up to 12 additional weeks.

RESULTS:

24 participants (72.7%) achieved responder status during at least one rating with dTMS continuation -- 20 (60.6%) within four weeks, with 13 (39.4%) consistently meeting response criteria for the duration of the study. 20 (63.6%) achieved remission status at some point during treatment continuation.

CONCLUSIONS:

A significant proportion of acute course non-responders to dTMS treatment eventually respond with continued treatment. Continuing TMS treatment beyond the acute course for non-responders may result in eventual response in over half of these individuals.

KEYWORDS:

Clinical research; Randomized clinical trial; Transcranial magnetic stimulation; Treatment-resistant depression

PMID:
28330592
DOI:
10.1016/j.brs.2017.02.013
[Indexed for MEDLINE]

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