Seizure Induced by Deep Transcranial Magnetic Stimulation in an Adolescent with Depression

Area of Science:

• Neuroscience
• Psychiatry
• Medical Devices

Background:

• Deep transcranial magnetic stimulation (TMS) using an H-1 coil is FDA-approved for adult treatment-resistant depression (TRD).
• Limited research exists on the safety and efficacy of deep TMS for adolescent TRD.
• This report details a case from an investigational deep TMS protocol for an adolescent.

Observation:

• A 17-year-old unmedicated female with no prior seizure history participated in a deep TMS clinical trial.
• The patient experienced a generalized tonic-clonic seizure during active deep TMS treatment at 120% motor threshold, using parameters adapted from adult studies.
• The seizure resolved spontaneously, and no further seizures occurred during a 6-month follow-up.

Findings:

• A deep TMS-induced seizure occurred in an adolescent participant with TRD.
• The event happened during active treatment using parameters extrapolated from adult protocols.
• No adverse events were reported post-seizure during the follow-up period.

Implications:

• Deep TMS shows promise for adolescent TRD, but this case underscores potential seizure risks.
• Additional safety precautions may be necessary when administering deep TMS to adolescents.
• Further dose-finding studies are required to establish safe and effective adolescent-specific deep TMS parameters.