Bilateral sequential accelerated theta-burst stimulation for treatment-resistant depression: an open-label randomized...

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Trials

Background:

• Treatment-resistant depression (TRD) presents a significant clinical challenge.
• Novel therapeutic strategies are crucial for improving patient outcomes.
• Evaluating accelerated brain stimulation techniques is an active area of research.

Purpose of the Study:

• To compare the clinical effectiveness and feasibility of a novel bilateral sequential accelerated theta-burst stimulation (BS-aTBS) protocol against a standard intermittent TBS (a-iTBS) protocol in TRD patients.
• To assess the impact of BS-aTBS on depression severity, anxiety, suicidal ideation, sleep quality, and cognitive function.

Main Methods:

• A randomized controlled trial involving 94 TRD patients.
• Participants were assigned to either BS-aTBS or a-iTBS, receiving 10 daily sessions over 5 consecutive days.
• The primary outcome measure was the change in the Hamilton Depression Rating Scale (HDRS-24) score from baseline to week 5.

Main Results:

• Both BS-aTBS and a-iTBS significantly reduced HDRS-24 scores at weeks 1 and 5.
• The BS-aTBS group demonstrated significantly greater symptom improvement at both time points compared to a-iTBS.
• BS-aTBS also showed higher response rates and greater alleviation of anxiety and suicidal ideation at week 5.

Conclusions:

• The BS-aTBS protocol offers rapid, well-tolerated antidepressant effects in TRD patients, lasting for at least one month.
• BS-aTBS provides additional benefits for anxiety and suicidal ideation.
• With its clinical advantages and shorter treatment duration, BS-aTBS is a promising, feasible, and efficient treatment option for TRD.