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Updated: Jul 30, 2025
MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
Published on: August 11, 2015
Accelerated Repetitive Transcranial Magnetic Stimulation to Treat Major Depression: The Past, Present, and Future
Leo Chen1, Deborah C W Klooster, Martin Tik
1From the Monash Alfred Psychiatry Research Centre, Department of Psychiatry, Central Clinical School, Monash University, Melbourne, Australia (Drs. Chen, Thomas); Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin (UZGent), Ghent University, Ghent, Belgium (Drs. Klooster, Baeken); Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford University, Stanford, CA (Drs. Tik, Williams); Institute of Medical Science and Department of Psychiatry, University of Toronto, Canada (Dr. Downar); School of Medicine and Psychology, he Australian National University, Canberra, Australia (Dr. Fitzgerald).
Accelerated repetitive transcranial magnetic stimulation (rTMS) offers a faster treatment course for major depressive disorder. Multiple daily sessions are well-tolerated and show comparable efficacy to conventional rTMS.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Technology
Background:
- Repetitive transcranial magnetic stimulation (rTMS) is an established therapy for treatment-resistant major depressive disorder.
- Conventional rTMS involves 20-30 daily sessions over 4-6 weeks.
- Accelerated rTMS protocols deliver multiple sessions per day, reducing treatment duration.
Purpose of the Study:
- To synthesize a consensus on accelerated rTMS based on two decades of research.
- To propose nomenclature and optimization strategies for accelerated rTMS.
- To explore the potential of biomarkers for individualizing accelerated rTMS protocols.
Main Methods:
- Review and synthesis of existing research on accelerated rTMS.
- Analysis of study designs, stimulation parameters, and outcomes.
- Consideration of past, present (theta burst stimulation), and future directions in accelerated rTMS.
Main Results:
- Accelerated rTMS protocols are well-tolerated with no serious adverse effects.
- Antidepressant efficacy of accelerated rTMS is comparable to conventional once-daily rTMS.
- The potential for faster onset of antidepressant effects with accelerated rTMS remains uncertain.
Conclusions:
- Accelerated rTMS enhances clinical efficiency and reduces time demands for patients.
- Protocols with high pulse dose and multiple daily treatments show promise for improved efficacy.
- Future research should focus on optimizing protocols and utilizing biomarkers for personalized treatment.
