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Real-world case series of maintenance theta burst stimulation therapy following response to acute theta burst stimulation therapy for difficult-to-treat depression

Published online by Cambridge University Press:  21 May 2024

Yoshihiro Noda Open the ORCID record for Yoshihiro Noda [Opens in a new window] ,
Kyoshiro Fujii ,
Shinichiro Nakajima  and
Ryosuke Kitahata
Yoshihiro Noda*
Affiliation:
Shinjuku-Yoyogi Mental Lab Clinic, Tokyo, Japan Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
Kyoshiro Fujii
Affiliation:
Shinjuku-Yoyogi Mental Lab Clinic, Tokyo, Japan
Shinichiro Nakajima
Affiliation:
Shinjuku-Yoyogi Mental Lab Clinic, Tokyo, Japan Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
Ryosuke Kitahata
Affiliation:
Shinjuku-Yoyogi Mental Lab Clinic, Tokyo, Japan
*
Corresponding author: Yoshihiro Noda; Email: yoshi-tms@keio.jp
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Abstract

Objective

Treatment and management for difficult-to-treat depression are challenging, especially in a subset of patients who are at high risk for relapse and recurrence. The conditions that represent this subset are recurrent depressive disorder (RDD) and bipolar disorder (BD). In this context, we aimed to examine the effectiveness of maintenance transcranial magnetic stimulation (TMS) on a real-world clinical basis by retrospectively extracting data from the TMS registry data in Tokyo, Japan.

Methods

Data on patients diagnosed with treatment-resistant RDD and BD who received maintenance intermittent theta burst stimulation (iTBS) weekly after successful treatment with acute iTBS between March 2020 and October 2023 were extracted from the registry.

Results

All patients (21 cases: 10 cases with RDD and 11 cases with BD) could sustain response, and 19 of them further maintained remission. In this study, maintenance iTBS did not exacerbate depressive symptoms in any of the cases, but may rather have the effect of stabilizing the mental condition and preventing recurrence.

Conclusions

This case series is of great clinical significance because it is the first study to report on the effectiveness of maintenance iTBS for RDD and BD, with a follow-up of more than 2 years. Further validation with a randomized controlled trial design with a larger sample size is warranted.

Keywords

Maintenance transcranial magnetic stimulationintermittent theta burst stimulationtreatment-resistant depressionrecurrent depressive disorderbipolar depression
Type
Original Research
Information
CNS Spectrums , First View , pp. 1 - 10
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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