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Related Experiment Video

Updated: Jul 4, 2026

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
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MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder

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A 3-Month Follow-Up Pilot Study on Accelerated Intermittent Theta Burst Stimulation for Bipolar Depression.

Daan Neuteboom1,2, Urmi Pahladsingh1,3, Martijn C Steinbach1

  • 1Amsterdam UMC, University of Amsterdam, Adult Psychiatry, Amsterdam, the Netherlands.

Bipolar Disorders
|July 3, 2026
PubMed
Summary

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This summary is machine-generated.

Accelerated intermittent Theta Burst Stimulation (aiTBS) shows promise for treating treatment-resistant bipolar depression (TRBD), demonstrating significant antidepressant effects and good tolerability in a pilot study. Further research is needed to assess the long-term durability of these antidepressant effects.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Technology

Background:

  • Approximately 25% of bipolar disorder patients experience treatment-resistant bipolar depression (TRBD).
  • Accelerated intermittent Theta Burst Stimulation (aiTBS), a novel repetitive transcranial magnetic stimulation (rTMS) technique, utilizes theta wave frequencies to potentially enhance synaptic plasticity.
  • This pilot study investigated the safety, tolerability, and preliminary efficacy of aiTBS for TRBD.

Purpose of the Study:

  • To evaluate the safety and tolerability of aiTBS in patients with TRBD.
  • To assess the preliminary antidepressant efficacy of aiTBS in this patient population.
  • To explore the potential of aiTBS as a treatment option for TRBD.

Main Methods:

  • An open-label pilot study involving 8 patients (aged 43-64) with moderate-to-severe TRBD, meeting Hidalgo-Mazzei criteria.
Keywords:
accelerated intermittent theta burst stimulation (aiTBS)bipolar disorder (BD)non‐invasive brain stimulation (NIBS)repetitive transcranial magnetic stimulation (rTMS)treatment resistant bipolar depression (TRBD)

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  • Patients received eight daily sessions of aiTBS targeting the left dorsolateral prefrontal cortex (DLPFC) over five consecutive days.
  • Outcomes including safety, tolerability, and efficacy (measured by HDRS-17) were assessed at multiple time points up to 12 weeks post-treatment.

    • Main Results:

    • aiTBS was well-tolerated, with no serious adverse events (SAEs) reported.
    • The most common adverse events (AEs) were discomfort and fatigue (87.5%).
    • Significant reductions in Hamilton Depression Rating Scale (HDRS-17) scores were observed, indicating antidepressant effects, although durability was limited by 3 months.

    Conclusions:

    • aiTBS appears to be a safe and tolerable treatment for TRBD, with preliminary evidence of antidepressant efficacy.
    • The durability of aiTBS's antidepressant effects in TRBD may be limited.
    • Future randomized controlled trials (RCTs) are recommended to investigate relapse prevention and optimal maintenance strategies for aiTBS in TRBD.