Deep TMS in a resistant major depressive disorder: a brief report

Area of Science:

• Neuroscience
• Psychiatry
• Medical Devices

Background:

• Repetitive transcranial magnetic stimulation (rTMS) is an established treatment for major depression.
• A novel coil, the H1-coil, offers greater intracranial penetration for enhanced therapeutic effects.
• This study investigates the efficacy of the H1-coil for treatment-resistant major depression.

Purpose of the Study:

• To evaluate the effectiveness of deep transcranial magnetic stimulation (TMS) with the H1-coil in patients with major depressive disorder.
• To assess the H1-coil's potential as an alternative treatment for individuals unresponsive to conventional therapies.

Main Methods:

• Seven patients with major depression received deep TMS using the H1-coil.
• Treatment consisted of five sessions per week for four weeks, with 1,680 pulses per session at 120% motor threshold and 20 Hz frequency.
• Stimulation was delivered via a Magstim rapid 2 stimulator.

Main Results:

• Five out of seven patients completed the treatment protocol.
• One patient achieved remission (HDRS=9), three experienced over 50% reduction in HDRS scores, and one showed partial response (HDRS drop from 21 to 12).
• Average HDRS scores decreased, and average Hamilton Anxiety Rating Scale scores also reduced.

Conclusions:

• Deep TMS with the H1 coil appears similarly effective to rTMS for major depression, based on response and remission rates.
• The study's small sample size limits definitive comparisons regarding effectiveness and side effects.
• Further research with larger cohorts is necessary to validate these findings and explore side effect profiles.