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TMS Guided by EEG Eases Major Depression in Half the Session Time
Transcranial magnetic stimulation (TMS) guided by electroencephalography (EEG) is safe, effective, and associated with substantially shorter treatment times than standard left frontal TMS in patients with depression and anxiety disorders, according to an uncontrolled observational study published in the Journal of Affective Disorders.
Compared with antidepressant medications and psychological interventions, TMS takes less time, requires little patient effort, and has few side effects, the United Kingdom-based research team explained.
“Nevertheless,” researchers wrote, “remission rates are only about 1 in 3 with standard left frontal rapid stimulation, and up to 30 treatment sessions may be required.”
For the study, researchers investigated whether TMS guided by quantitative EEG improved the effectiveness of the intervention as opposed to left frontal TMS in 210 men and women with major depression and anxiety disorders, most of whom were already taking antidepressant medication.
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“[R]egions and frequencies of TMS were guided by quantitative EEG analysis to elicit recognizable phenotypes, neuromarkers integral to the genesis of major depression and anxiety disorder, dictating treatment parameters,” the study authors explained. To shorten treatment time, researchers used theta burst stimulation as the delivery mode.
According to the study, 47% of patients across both left frontal TMS and theta burst stimulation groups demonstrated at least a 50% drop in scores on the Hamilton Rating Scale for Depression over an average of 7.03 ± 0.3 treatment sessions. An additional 29% achieved a score decrease between 30% and 50%.
Within sessions, theta burst stimulation almost halved treatment time compared with left frontal TMS, the study showed. Effect sizes for both treatments were large: 1.43 with left frontal TMS and 1.87 with theta burst stimulation.
“TMS and theta burst stimulation are valuable additional or alternative treatments in depression,” researchers wrote.
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