Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-14T17:03:36.617Z Has data issue: false hasContentIssue false

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*
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

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.

Type
Original Research
Copyright
© The Author(s), 2024. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rush, AJ, Aaronson, ST, Demyttenaere, K. Difficult-to-treat depression: a clinical and research roadmap for when remission is elusive. Aust N Z J Psychiatry. 2019;53:109118.CrossRefGoogle ScholarPubMed
Cowen, PJ. Backing into the future: pharmacological approaches to the management of resistant depression. Psychol Med. 2017;47:25692577.CrossRefGoogle Scholar
Tundo, A, De Filippis, R, Proietti, L. Pharmacologic approaches to treatment resistant depression: evidences and personal experience. World J Psychiatry. 2015;5:330341.CrossRefGoogle ScholarPubMed
Voineskos, D, Daskalakis, ZJ, Blumberger, DM. Management of treatment-resistant depression: challenges and strategies. Neuropsychiatr Dis Treat. 2020;16:221234.CrossRefGoogle ScholarPubMed
Pezawas, L, Angst, J, Kasper, S. Recurrent brief depression revisited. Int Rev Psychiatry. 2005;17:6370.CrossRefGoogle Scholar
Bowden, CL, Perlis, RH, Thase, ME, et al. Aims and results of the NIMH systematic treatment enhancement program for bipolar disorder (STEP-BD). CNS Neurosci Ther. 2012;18:243249.CrossRefGoogle ScholarPubMed
Diaz, AP, Fernandes, BS, Quevedo, J, Sanches, M, Soares, JC. Treatment-resistant bipolar depression: concepts and challenges for novel interventions. Braz J Psychiatry. 2022;44:178186.CrossRefGoogle ScholarPubMed
Goes, FS. Diagnosis and management of bipolar disorders. BMJ. 2023;381:e073591.CrossRefGoogle ScholarPubMed
Judd, LL, Akiskal, HS, Schettler, PJ, et al. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry. 2003;60:261269.CrossRefGoogle ScholarPubMed
Judd, LL, Akiskal, HS, Schettler, PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002;59:530537.CrossRefGoogle ScholarPubMed
Hardeveld, F, Spijker, J, De Graaf, R, Nolen, WA, Beekman, AT. Recurrence of major depressive disorder and its predictors in the general population: results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Psychol Med. 2013;43:3948.CrossRefGoogle ScholarPubMed
Hardeveld, F, Spijker, J, De Graaf, R, Nolen, WA, Beekman, AT Prevalence and predictors of recurrence of major depressive disorder in the adult population. Acta Psychiatr Scand. 2010;122:184191.CrossRefGoogle ScholarPubMed
Vazquez, GH, Holtzman, JN, Lolich, M, Ketter, TA, Baldessarini, RJ. Recurrence rates in bipolar disorder: systematic comparison of long-term prospective, naturalistic studies versus randomized controlled trials. Eur Neuropsychopharmacol. 2015;25:15011512.CrossRefGoogle ScholarPubMed
Senova, S, Cotovio, G, Pascual-Leone, A, Oliveira-Maia, AJ. Durability of antidepressant response to repetitive transcranial magnetic stimulation: systematic review and meta-analysis. Brain Stimul. 2019;12:119128.CrossRefGoogle ScholarPubMed
Li, X, Nahas, Z, Anderson, B, Kozel, FA, George, MS. Can left prefrontal rTMS be used as a maintenance treatment for bipolar depression? Depress Anxiety. 2004;20:98100.CrossRefGoogle ScholarPubMed
O’reardon, JP, Blumner, KH, Peshek, AD, Pradilla, RR, Pimiento, PC Long-term maintenance therapy for major depressive disorder with rTMS. J Clin Psychiatry. 2005;66:15241528.CrossRefGoogle ScholarPubMed
Langguth, B, Landgrebe, M, Zowe, M, Gerst, M, Hajak, G, Eichhammer, P. Repetitive transcranial magnetic stimulation for maintenance treatment of depression: a case report. J Clin Psychiatry. 2006;67:835836.CrossRefGoogle ScholarPubMed
Fitzgerald, PB, Benitez, J, De Castella, AR, Brown, TL, Daskalakis, ZJ, Kulkarni, J Naturalistic study of the use of transcranial magnetic stimulation in the treatment of depressive relapse. Aust N Z J Psychiatry. 2006;40:764768.CrossRefGoogle ScholarPubMed
Chatterjee, B, Kumar, N, Jha, S. Role of repetitive transcranial magnetic stimulation in maintenance treatment of resistant depression. Indian J Psychol Med. 2012;34:286289.CrossRefGoogle ScholarPubMed
Cristancho, MA, Helmer, A, Connolly, R, Cristancho, P, O’reardon, JP. Transcranial magnetic stimulation maintenance as a substitute for maintenance electroconvulsive therapy: a case series. J ECT. 2013;29:106108.CrossRefGoogle ScholarPubMed
Noda, Y, Daskalakis, ZJ, Ramos, C, Blumberger, DM. Repetitive transcranial magnetic stimulation to maintain treatment response to electroconvulsive therapy in depression: a case series. Front Psychiatry. 2013;4:73.CrossRefGoogle ScholarPubMed
Richieri, R, Guedj, E, Michel, P, et al. Maintenance transcranial magnetic stimulation reduces depression relapse: a propensity-adjusted analysis. J Affect Disord. 2013;151:129135.CrossRefGoogle ScholarPubMed
Kelly, MS, Oliveira-Maia, AJ, Bernstein, M, et al. Initial response to transcranial magnetic stimulation treatment for depression predicts subsequent response. J Neuropsychiatry Clin Neurosci. 2017;29:179182.CrossRefGoogle ScholarPubMed
Pridmore, S, Erger, S, Rybak, M, Kelly, e, may, t. Early relapse (ER) transcranial magnetic stimulation (TMS) in treatment resistant major depression. Brain Stimul. 2018;11:10981102.CrossRefGoogle Scholar
Matsuda, Y, Yamazaki, R, Shigeta, M, Kito, S. A 12-month maintenance therapy using repetitive transcranial magnetic stimulation for treatment-resistant depression: a report of two cases. Asian J Psychiatry. 2022;68:102970.CrossRefGoogle ScholarPubMed
Cosmo, C, Zandvakili, A, Petrosino, NJ, Berlow, YA, Philip, NS. Repetitive transcranial magnetic stimulation for treatment-resistant depression: recent critical advances in patient care. Curr Treat Options Psychiatry. 2021;8:4763.CrossRefGoogle ScholarPubMed
Wilson, S, Croarkin, PE, Aaronson, ST, et al. Systematic review of preservation TMS that includes continuation, maintenance, relapse-prevention, and rescue TMS. J Affect Disord. 2022;296:7988.CrossRefGoogle ScholarPubMed
D’andrea, G, Mancusi, G, Santovito, MC, et al. Investigating the role of maintenance TMS protocols for major depression: systematic review and future perspectives for personalized interventions. J Pers Med. 2023;13:697.CrossRefGoogle ScholarPubMed
Fukuda, AM, Tirrell, E, Gobin, AP, Carpenter, LL. Repetitive transcranial magnetic stimulation for depression relapse or recurrence: naturalistic retreatment series outcomes. Brain Stimul. 2019;12:13281329.CrossRefGoogle ScholarPubMed
Noda, Y, Kizaki, J, Takahashi, S, Mimura, M. TMS Database Registry Consortium Research Project in Japan (TReC-J) for future personalized psychiatry. J Pers Med. 2022;12:844.CrossRefGoogle ScholarPubMed
Ekman, CJ, Popiolek, K, Boden, R, Nordenskjold, A, Lundberg, J. Outcome of transcranial magnetic intermittent theta-burst stimulation in the treatment of depression - a Swedish register-based study. J Affect Disord. 2023;329:5054.CrossRefGoogle ScholarPubMed
Montgomery, SA, Asberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382389.CrossRefGoogle ScholarPubMed
Hamilton, M. Rating depressive patients. J Clin Psychiatry. 1980;41:2124.Google ScholarPubMed
Beam, W, Borckardt, JJ, Reeves, ST, George, MS. An efficient and accurate new method for locating the F3 position for prefrontal TMS applications. Brain Stimul. 2009;2:5054.CrossRefGoogle ScholarPubMed
Chang, J, Chu, Y, Ren, Y, Li, C, Wang, Y, Chu, XP. Maintenance treatment of transcranial magnetic stimulation (TMS) for treatment-resistant depression patients responding to acute TMS treatment. Int J Physiol Pathophysiol Pharmacol. 2020;12:128133.Google ScholarPubMed
Levkovitz, Y, Isserles, M, Padberg, F, et al. Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry. 2015;14:6473.CrossRefGoogle ScholarPubMed
Dunner, DL, Aaronson, ST, Sackeim, HA, et al. A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: durability of benefit over a 1-year follow-up period. J Clin Psychiatry. 2014;75:13941401.CrossRefGoogle Scholar
Harel, EV, Rabany, L, Deutsch, L, Bloch, Y, Zangen, A, Levkovitz, Y. H-coil repetitive transcranial magnetic stimulation for treatment resistant major depressive disorder: an 18-week continuation safety and feasibility study. World J Biol Psychiatry. 2014;15:298306.CrossRefGoogle ScholarPubMed
Fitzgerald, PB, Grace, N, Hoy, KE, Bailey, M, Daskalakis, ZJ. An open label trial of clustered maintenance rTMS for patients with refractory depression. Brain Stimul. 2013;6:292297.CrossRefGoogle ScholarPubMed
Janicak, PG, Nahas, Z, Lisanby, SH, et al. Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatment of pharmacoresistant major depression: assessment of relapse during a 6-month, multisite, open-label study. Brain Stimul. 2010;3:187199.CrossRefGoogle ScholarPubMed
Connolly, KR, Helmer, A, Cristancho, MA, Cristancho, P, O’reardon, JP. Effectiveness of transcranial magnetic stimulation in clinical practice post-FDA approval in the United States: results observed with the first 100 consecutive cases of depression at an academic medical center. J Clin Psychiatry. 2012;73:e567e573.CrossRefGoogle ScholarPubMed
Gama-Chonlon, L, Scanlan, JM, Allen, RM. Could bipolar depressed patients respond better to rTMS than unipolar depressed patients? A naturalistic, observational study. Psychiatry Res. 2022;312:114545.CrossRefGoogle ScholarPubMed
Bukh, JD, Andersen, PK, Kessing, LV Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression--a prospective 5-year follow-up study. Psychol Med. 2016;46:11511161.CrossRefGoogle ScholarPubMed
Gilman, SE, Dupuy, JM, Perlis, RH Risks for the transition from major depressive disorder to bipolar disorder in the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2012;73:829836.CrossRefGoogle ScholarPubMed
Holma, KM, Melartin, TK, Holma, IA, Isometsa, ET Predictors for switch from unipolar major depressive disorder to bipolar disorder type I or II: a 5-year prospective study. J Clin Psychiatry. 2008;69:12671275.CrossRefGoogle ScholarPubMed
Jo, YT, Joo, SW, Kim, H, et al. Diagnostic conversion from unipolar to bipolar affective disorder-a population-based study. J Affect Disord. 2022;301:448453.CrossRefGoogle ScholarPubMed
Nestsiarovich, A, Reps, JM, Matheny, ME, et al. Predictors of diagnostic transition from major depressive disorder to bipolar disorder: a retrospective observational network study. Transl Psychiatry. 2021;11:642.CrossRefGoogle ScholarPubMed
Tse, AC, Fok, ML, Yim, LC, Leung, MM, Leung, CM. Diagnostic conversion to bipolar disorder in unipolar depressed patients in Hong Kong: a 20-year follow-up study. J Affect Disord. 2021;286:9498.CrossRefGoogle Scholar
Elsayed, OH, Ercis, M, Pahwa, M, Singh, B. Treatment-resistant bipolar depression: therapeutic trends, challenges and future directions. Neuropsychiatr Dis Treat. 2022;18:29272943.CrossRefGoogle ScholarPubMed