| Paper Authors: | Peter Giacobbe, Karim Mithani, Ying Meng, Fidel Vila-Rodriguez, Zafiris Daskalakis, Jonathan Downar, Daniel Blumberger |
| Post Author(s): | Alice Erchov, Lisa Ridgway, Fidel Vila-Rodriguez |
| Download the research article: | Giacobbe et al. – 2020 – Evaluation of the effects of rTMS on self-reported quality of life and disability in treatment-resistant depression |
Introduction
Many studies have looked at how new treatments such as repetitive Transcranial Magnetic Stimulation (rTMS) or the shortened version, intermittent Theta Burst Stimulation (iTBS) therapies are effective in treating symptoms of depression in a safe, effective, and non-invasive way – even in those who hadn’t responded to medication in the past. However, few studies have ever assessed patient-reported changes in quality of life and levels of disability after treatment to see whether these improve at the same time or in the same way as symptoms of depression.
Methods
This study used data from a previous trial, called THREE-D, to look at patients’ depressive symptoms, quality of life, and extent of disability as it changed across 4-6 weeks of rTMS or iTBS treatment. We looked at these outcomes before treatment, 1 week after treatment, and 12 weeks after treatment.
- Disability was measured on a scale from 0-30, with higher scores meaning greater levels of disability (e.g., how much have your symptoms impacted your work, school, social life, and home responsibilities?)
- Quality of life was measured on a scale from 14-70, with higher scores meaning a better quality of life (e.g., how would you rate your satisfaction with your mood, work, physical health, relationships, etc.)
Results
- Quality of life increased by 8.1 points by 1 week after the end of treatment and stayed 7.9 points above pre-treatment scores even 4 months after the end of treatment, on average.
- The level of disability decreased by 5.8 points by 1 week after the end of treatment and was 6.8 points lower than pre-treatment scores 4 months after the end of treatment, on average.
- Those who saw improvements in depressive symptoms after treatment (77% of patients) had bigger improvements in quality of life and disability, compared to those who did not respond to rTMS/iTBS.
- Improvements in symptoms of depression, disability, and quality of life were equal across rTMS and iTBS treatment approaches.
Conclusion
This study showed that rTMS/iTBS are effective at not only treating depression, but also real-life outcomes – specifically, quality of life and level of disability. This means that rTMS/iTBS can improve day-to-day function in people who have treatment-resistant depression. The results of this study also show that these improvements are closely related to depression symptoms, and that even the shortened iTBS protocols (which only take 3.5 mins per session) are equally effective at improving functional outcomes as the typical, longer rTMS approach (37.5 mins per session).