TMS Therapy Research


J Clin Psychiatry. 2014, 75 (12): 1394-1401. DOI: 10.4088/JCP.13m08977.

A multisite, naturalistic observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: durability of benefit over a 1-year follow-up period. Dunner DL, Aaronson ST, Sackheim HA, Janicak PG, Carpenter LL, Boyadjis T, Brock DG, Bonneh-Barkay D, Cook IA, Lanocha K, Solvason HB, Demitrack MA.


CONCLUSION: TMS demonstrates a statistically and clinically meaningful durability of acute benefit over 12 months of follow-up. This was observed under a pragmatic regimen of continuation antidepressant medication and access to TMS retreatment for symptom recurrence.


Curr Opin Psychiatry. 2013 Jan; 26(1): 13–18. doi: 10.1097/YCO.0b013e32835ab46d.

The Expanding Evidence Base for rTMS Treatment of Depression. George MS, Johnson RH, Taylor JJ, Short EB.


CONCLUSION: These recent studies suggest that daily left prefrontal TMS over several weeks as a treatment for depression appears to not only have efficacy in rigorous randomized controlled trials, but is effective in real world settings, with remission in 30–40% of patients. The TMS antidepressant effect, once achieved, appears to be as durable as with other antidepressant medications or interventions.


Clin Psychopharmacol Neurosci. 2013, 11(2): 53-59. DOI: 10.9758/cpn.2013.11.2.53.

Use of Repetitive Transcranial Magnetic Stimulation for Treatment in Psychiatry. Andre Aleman.


CONCLUSION: The present review briefly describes the background of this novel treatment modality and summarizes evidence from clinical trials into the efficacy of rTMS for depression. It can be concluded that rTMS induces alterations in neural networks relevant for psychiatric disorders.


Depress Anxiety. 2012 Jul;29(7):587-96. doi: 10.1002/da.21969.

Epub 2012 Jun 11. Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Carpenter LL, Janicak PG, Aaronson ST, Boyadjis T, Brock DG, Cook IA, Dunner DL, Lanocha K, Solvason HB, Demitrack MA.


CONCLUSION: Outcomes demonstrated response and adherence rates similar to research populations. These data indicate that TMS is an effective treatment for those unable to benefit from initial antidepressant medication.


Curr Opin Psychiatry. 2012 Nov 14.

[Epub ahead of print] The expanding evidence base for rTMS treatment of depression. George MS, Taylor JJ, Short EB. Psychiatry Department, Brain Stimulation Laboratory, Medical University of South Carolina, and Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.


CONCLUSION: These recent studies suggest that daily left prefrontal TMS over several weeks as a treatment for depression not only appears to have efficacy in rigorous randomized controlled trials, but is effective in real-world settings, with remission in 30-40% of patients. The TMS antidepressant effect, once achieved, appears to be as durable as with other antidepressant medications or interventions. Much more research is needed, particularly with issues such as the TMS coil location, stimulation intensity and frequency, and dosing strategy.


Clin Pract Epidemiol Ment Health. 2011;7:167-77. doi: 10.2174/1745017901107010167.

Epub 2011 Oct 26.Meta-Review of Metanalytic Studies with Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Major Depression. Dell'osso B, Camuri G, Castellano F, Vecchi V, Benedetti M, Bortolussi S, Altamura AC. Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy.


CONCLUSION: rTMS seems to be an effective and safe brain stimulation technique for the treatment of medication refractory depression. Nevertheless, further studies are needed to better define specific stimulation-related issues, such as duration of treatment as well as durability of effects and predictors of response.


Arch Gen Psychiatry. 2010 May;67(5):507-16. doi: 10.1001/archgenpsychiatry.2010.46.

Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. George MS, Lisanby SH, Avery D, McDonald WM, Durkalski V, Pavilcova M, Anderson B, Nahas Z, Bulow P, Zarkowski P, Holtzheimer PE 3rd, Schwartz T, Sackeim HA. Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.


CONCLUSION: Daily left prefrontal rTMS as monotherapy produced statistically significant and clinically meaningful antidepressant therapeutic effects greater than sham.


Brain Stimul. 2010 Oct;3(4):187-99. doi: 10.1016/j.brs.2010.07.003. Epub 2010 Aug 11.

Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatment of pharmacoresistant major depression: assessment of relapse during a 6-month, multisite, open-label study. Janicak PG, Nahas Z, Lisanby SH, Solvason HB, Sampson SM, McDonald WM, Marangell LB, Rosenquist P, McCall WV, Kimball J, O'Reardon JP, Loo C, Husain MH, Krystal A, Gilmer W, Dowd SM, Demitrack MA, Schatzberg AF. Department of Psychiatry, Rush University Medical Center, Chicago, Illinois 60612, USA.


CONCLUSION: These initial data suggest that the therapeutic effects of TMS are durable and that TMS may be successfully used as an intermittent rescue strategy to preclude impending relapse.


Arch Gen Psychiatry. 2003 Oct;60(10):1002-8.

Transcranial magnetic stimulation in the treatment of depression: a double-blind, placebo-controlled trial. Fitzgerald PB, Brown TL, Marston NA, Daskalakis ZJ, De Castella A, Kulkami J. Alfred Psychiatry Research Centre, The Alfred Hospital, and the Department of Psychological Medicine, Monash University, Australia.


CONCLUSION: Both HFL-TMS and LFR-TMS have treatment efficacy in patients with medication-resistant major depression. Treatment for at least 4 weeks is necessary for clinically meaningful benefits to be achieved. Treatment with LFR-TMS may prove to be an appropriate initial repetitive TMS strategy in depression taking into account safety, tolerability, and efficacy considerations.


J ECT. 2001 Dec;17(4):259-63.

Lack of adverse cognitive effects of 1 Hz and 20 Hz repetitive transcranial magnetic stimulation at 100% of motor threshold over left prefrontal cortex in depression. Speer AM, Repella JD, Figueras S, Demian MK, Kimbrell TA, Wasserman EM, Post RM. Biological Psychiatry Branchm National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892, USA.


CONCLUSION: Cognitive functioning in many domains following 2 weeks of 1 Hz or 20 Hz rTMS at 100% MT over the left dorsolateral prefrontal cortex in depressed patients is not disrupted.


Can J Psychiatry. 2001 Oct; 46(8):720-7.

Transcranial magnetic stimulation in the treatment of mood disorder: a review and comparison with electroconvulsive therapy. Hasey G. Regional Mood Disorders Program, Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.


CONCLUSION: The antidepressant and antimanic effects of rTMS depend on technical considerations such as stimulus frequency, intensity, and magnetic coil placement, which may not yet be optimized. Biological heterogeneity among the patients treated with rTMS may also contribute to differing efficacy across clinical trials. rTMS may possess tremendous potential as a treatment for mood disorder, but this has not yet been realized. rTMS must still be regarded as an experimental intervention requiring further refinement.

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