Intermittent Theta-Burst Stimulation and Depressive Symptoms in Major Depressive Disorder: A Randomized Clinical...

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Trials

Background:

• Intermittent theta-burst stimulation (iTBS) is an established treatment for major depressive disorder (MDD).
• Sham-controlled evidence for once-daily iTBS protocols in MDD is limited.
• Assessing the efficacy of a fixed 10-session once-daily iTBS protocol is crucial.

Purpose of the Study:

• To determine if 10 sessions of once-daily iTBS is superior to sham iTBS for adults with MDD.
• To evaluate the short-term and sustained effects of iTBS on depressive symptoms.
• To compare clinician-rated and self-reported depression scores.

Main Methods:

• A randomized clinical trial involving 73 adults with MDD (MADRS score ≥ 20).
• Participants received 10 weekday sessions of iTBS or sham stimulation targeting the left dorsolateral prefrontal cortex.
• Depression scores (MADRS, BDI-II) were assessed on days 5, 10, and at 4-week follow-up.

Main Results:

• iTBS demonstrated superiority over sham for MADRS scores on day 10 (p=.01) and day 5 (p=.04).
• No significant difference was found between iTBS and sham for BDI-II scores on day 10 (p=.30).
• The observed benefits were not sustained at the 4-week follow-up, with improvements noted in the sham group.

Conclusions:

• A 10-session schedule of once-daily iTBS led to greater reductions in clinician-rated depressive symptoms compared to sham during treatment.
• The treatment was well-tolerated with mild, transient adverse events.
• Findings underscore the importance of treatment duration and extended follow-up in evaluating clinical response for MDD.