Is more better? Comparing 600, 1200 and 1800 pulses/session (p/s) of intermittent theta-burst stimulation (iTBS) for the treatment of depression

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-03-06 DOI:10.1016/j.jpsychires.2025.03.006

Katharina Kerkel , Stefan Schoisswohl , Berthold Langguth , Mohamed A. Abdelnaim , Jost Bernet , Martin Schecklmann , Andreas Reissmann

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引用次数: 0

Abstract

Introduction

Repetitive Transcranial magnetic stimulation (rTMS) is a non-invasive therapy for treatment-resistant disorders. Intermittent theta-burst stimulation (iTBS) has emerged as a favorite treatment protocol for the treatment of therapy resistant depression, with the tendency to administer an increasing number of pulses/session (p/s).

Methods

We retrospectively analyzed the records of 215 in- and out-patients, suffering from unipolar or bipolar depressive disorder in a German tertiary care hospital between January 2021 and September 2024. All patients received left prefrontal iTBS with either 600 (n = 68), 1200 (n = 67) or 1800 (n = 80) p/s over the course of 15–20 days. Depressive symptoms were assessed with the 21-item Hamilton Depression Rating Scale (HAMD-21) and the Major Depression Inventory (MDI) before and at the end of the respective treatment. Side effects were quantified by the number of patients reporting a side effect in at least one of the rTMS sessions.

Results

In all groups, the HAMD-21 and MDI scores improved significantly. There was no significant difference between the three groups (HAMD-21: p = .198, MDI: p = .281). Further, this result equally applies to men and women (all p′s > .145). No serious side effects occurred. Patients who were treated with 600 p/s reported most side effects.

Conclusion

Our retrospective analysis suggests that an increase of p/s from 600 to 1200 or 1800 does not result in more pronounced antidepressant effects.

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;