Clinical outcomes following five-day accelerated intermittent theta burst stimulation for treatment-resistant depression in routine clinical practice: A prospective naturalistic cohort study.

IF 4.6 3区医学 Q2 CLINICAL NEUROLOGY

CNS Spectrums Pub Date : 2026-10-15 DOI:10.1017/S1092852926101205

Asmi Khanna, Adrian Espiritu, Lynn Zhu, Mervin Blair, Olivia Giovannetti, Amanda Abate, Janice Knight, Luisa Deutsch, Robyn Waxman, Amer M Burhan

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引用次数: 0

Abstract

Objectives: Treatment-resistant depression (TRD) is a debilitating condition occurring in major depressive disorder (MDD) and bipolar II disorder (BP-II). Intermittent theta burst stimulation (iTBS) is an established neuromodulation approach for TRD, but standard delivery requires once-daily sessions over several weeks. Accelerated iTBS (aiTBS) may reduce treatment burden by temporally compressing delivery. We evaluated the implementation, tolerability, and clinical outcomes associated with a 5-day aiTBS schedule for adults experiencing TRD in MDD and BP-II.

Methods: In this single-center, open-label, uncontrolled, prospective naturalistic cohort study, adults with MDD or BP-II experiencing TRD received 30 iTBS sessions (600 pulses/session; total 18 000 pulses) over 5 days with 50-minute inter-session intervals. HAMD-17 was assessed at baseline, post-treatment, and 2-month follow-up. Secondary outcomes included Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), baseline Clinical Global Impression-Severity (CGI-S), post-treatment/follow-up CGI-I, response/remission rates, and adverse events. Longitudinal changes were evaluated using linear mixed-effects models.

Results: Forty-six participants contributed longitudinal data (mean age 44.3 years; 54.4% male). HAMD-17 response rates were 28.3% (n = 13) post-treatment and 37.0% (n = 17) at follow-up; remission rates were 26.1% (n = 12) and 32.6% (n = 15), respectively. Improvements were also observed on PHQ-9 and GAD-7. On CGI-I, 52.2% were rated improved post-treatment and 60.9% at follow-up. The most common adverse event was transient, non-serious stimulation-site pain.

Conclusions: The 5-day aiTBS schedule was logistically feasible, well-tolerated, and associated with reductions in depressive and anxiety symptom scores in a real-world TRD cohort. Randomized sham-controlled trials are needed to confirm these findings.

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在常规临床实践中，5天加速间歇性θ波爆发刺激治疗难治性抑郁症的临床结果：一项前瞻性自然队列研究

目的：难治性抑郁症（TRD）是发生在重度抑郁症（MDD）和双相情感障碍（BP-II）中的一种衰弱性疾病。间歇性θ波爆发刺激（iTBS）是治疗TRD的既定神经调节方法，但标准的治疗方法需要每天一次，持续数周。加速iTBS （aiTBS）可以通过暂时压缩输送来减轻治疗负担。我们评估了在MDD和BP-II中经历TRD的成人5天aiTBS计划的实施、耐受性和临床结果。方法：在这项单中心、开放标签、非控制、前瞻性自然队列研究中，患有重度抑郁症或BP-II型TRD的成年人接受了30次iTBS治疗（600次脉冲/次，总共18000次脉冲），持续5天，每次间隔50分钟。在基线、治疗后和2个月随访时评估HAMD-17。次要结局包括患者健康问卷-9 （PHQ-9）、广泛性焦虑障碍-7 （GAD-7）、基线临床总体印象严重程度（CGI-S）、治疗后/随访cgi - 1、缓解率/缓解率和不良事件。使用线性混合效应模型评估纵向变化。结果：46名参与者提供了纵向数据（平均年龄44.3岁，54.4%为男性）。治疗后HAMD-17的有效率为28.3% (n = 13)，随访时为37.0% (n = 17)；缓解率分别为26.1% （n = 12）和32.6% （n = 15）。PHQ-9和GAD-7也有改善。在CGI-I上，52.2%的人认为治疗后改善，60.9%的人认为随访后改善。最常见的不良事件是短暂的、不严重的刺激部位疼痛。结论：在现实世界的TRD队列中，5天的aiTBS计划在逻辑上是可行的，耐受性良好，并且与抑郁和焦虑症状评分的降低有关。需要随机的假对照试验来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Spectrums 医学-精神病学

CiteScore

6.20

自引率

6.10%

发文量

239

审稿时长

>12 weeks

期刊介绍： CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.