Can we shorten TMS weeks?
In the NINET Lab’s previous studies involving repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant depression (TRD), the rTMS “treatment course” lasts 4-6 weeks, with one treatment each day. Could the treatment be done in fewer weeks if people got treated more than once a day?
This is the question that the current study examines. Instead of one treatment per day, this study compares the effectiveness of two treatments per day. For each treatment, researchers used a type of rTMS called intermittent theta burst stimulation (iTBS).
Does shorter rTMS work for Older Adults?
In traditional bilateral (two-sided) rTMS, it takes 47.5 minutes to do the treatment. To address long treatment times, theta burst stimulation (TBS) has been developed. TBS uses patterned bursts of stimulation that may achieve similar effects to standard rTMS in about 4 minutes. The shorter appointment time may increase the number of older adults with TRD who can access this treatment. This study was designed to assess whether this quicker bilateral TBS protocol was as effective as the standard, longer bilateral rTMS in reducing depressive symptoms in older adults with TRD.
Can rTMS treatments be shorter?
For treatment resistant-depression (TRD), there is a standard form of repetitive transcranial magnetic stimulation (rTMS) treatment. This form lasts for 37.5 minutes; a considerable amount of time for one treatment. The goal of this study was to see if the time rTMS treatments take can be reduced while remaining as effective by using a new form, called intermittent theta burst stimulation (iTBS).
Two-Sided rTMS Treatment is Better Than One-Sided for People With Treatment-Resistant Depression
Repetitive transcranial magnetic stimulation (rTMS) offers an alternative treatment for people with treatment-resistant depression. This study compared two-sided rTMS treatment to one-sided rTMS and sham (placebo) rTMS. This study also addressed limitations in other studies by using MRI to increase individualization of placing the rTMS device and extending the treatment weeks to up to six weeks.
Predicting rTMS Treatment Success for Depression Using Brain Connectivity
While repetitive transcranial magnetic stimulation (rTMS) is an effective therapy for TRD, it’s difficult to predict which patients will benefit most. To address this, finding biological markers (biomarkers) that can predict treatment response is a crucial goal for providing personalized care. This study used resting-state functional magnetic resonance imaging (fMRI) to explore brain activity patterns, aiming to discover neuroimaging biomarkers that can distinguish patients who will respond to rTMS from those who won’t.
Is taking bupropion during rTMS treatment associated with seizures?
The researchers of this paper attempted to determine if seizure risk increased when receiving rTMS and taking an antidepressant called bupropion (Wellbutrin). Researchers found that while rTMS-induced seizures are uncommon and may be linked to factors like sleep deprivation, taking multiple medications, or pre-existing neurological conditions, the review found no cases of rTMS-induced seizures in patients taking bupropion alone. This suggests that taking bupropion should not be considered a reason to avoid rTMS treatment.
rTMS & Depression: Are there other regions we should treat?
People with depression have altered activity in some parts of the brain. To treat depression, we can attempt to change this altered activity by using rTMS. However, the brain region we typically apply rTMS to only achieves remission rates of 30% to 35%. This has led researchers to explore alternative target regions that may result in a higher remission rate.
Measuring the coordination of brain regions can predict who will benefit from rTMS for depression
In this study, researchers propose a possible measurement that may be able to predict if an individual will positively respond to repetitive transcranial magnetic stimulation (rTMS) treatment.
Magnetic Seizure Therapy (MST) can Treat Depression by Changing the Structure and Function of our Brains
Magnetic Seizure Therapy (MST) is similar to rTMS: it is a safe, painless, effective, and non-invasive way to treat even severe depression that hasn’t improved with antidepressants. MST also uses a device placed on the scalp to deliver a magnetic field that disrupts the brain’s electrical activity. However, MST is stronger. In fact, it is intended to elicit a closely-monitored seizure that is then thought to rewire the brain for the better. The researchers of the current study were wondering if changes in the brain structure (size) and function (activity) were related to improvements in depression after MST.
Memory-Related Regions of the Brain Function Differently in Those with Treatment-Resistant Depression
Depression doesn’t just affect the way people feel, it also affects the way people think. Specifically, a lot of people with depression notice that their memory might have become worse: they may have difficulty studying for school exams, misplace their things, or forgetting what they needed from the store. Many studies have looked into why this might be, looking particularly at the structure of our brain’s memory center, but not its function. The researchers of the current study were wondering if changes in the brain structure (size) and function (activity) were related to differences in memory among people with treatment-resistant depression, when compared to those without.