An accelerated course of TMS using intermittent theta burst for veterans with major depressive disorder: A case series.

IF 1.5 4区医学 Q3 PSYCHIATRY

Annals of Clinical Psychiatry Pub Date : 2023-05-01 DOI:10.12788/acp.0110

Zachary D Zuschlag, Laura Bajor, Kimberly Van Trees, Sean Philips, Greg Sullivan, Christine Burke, F Andrew Kozel

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引用次数: 2

Abstract

Background: Transcranial magnetic stimulation (TMS) is a neuro-modulation technique for treatment-resistant major depressive disorder (MDD). Standard TMS protocols for MDD involve once-daily treatment for 6 to 9 weeks. We report a case series of an accelerated TMS protocol for outpatient MDD treatment.

Methods: From July 2020 through January 2021, patients deemed appropriate candidates for TMS treatment were offered an accelerated TMS protocol consisting of intermittent theta burst stimulation (iTBS) applied to the left dorsolateral prefrontal cortex, localized by the Beam F3 method, and consisting of 5 treatments daily for 5 days. Assessment scales were obtained as part of standard clinical care.

Results: A total of 19 veterans received the accelerated protocol and 17 completed treatment. Statistically significant mean reductions from baseline to end of treatment were observed across all assessment scales. Remission and response rates, as defined by changes in Montgomery-Åsberg Depression Rating Scale scores, were 47.1% and 64.7%, respectively. Treatments were well tolerated without unexpected or serious adverse events.

Conclusions: This case series details the safety and efficacy of an accelerated iTBS TMS protocol consisting of 25 treatments over 5 days. Improved depressive symptoms were observed, with remission and response rates similar to standard TMS protocols of daily TMS for ≥6 weeks.

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使用间歇性θ波爆发的经颅磁刺激加速过程对患有重度抑郁症的退伍军人:一个病例系列。

背景:经颅磁刺激(TMS)是一种治疗难治性重度抑郁症(MDD)的神经调节技术。治疗重度抑郁症的标准经颅磁刺激方案包括每天一次，持续6至9周。我们报告一个病例系列的加速经颅磁刺激方案的门诊MDD治疗。方法:从2020年7月到2021年1月，被认为适合TMS治疗的患者接受了加速TMS方案，该方案包括应用于左背外侧前额皮质的间歇性θ波爆发刺激(iTBS)，通过Beam F3方法定位，每天5次治疗，持续5天。评估量表作为标准临床护理的一部分。结果:共有19名退伍军人接受了加速方案，17名退伍军人完成了治疗。从基线到治疗结束，所有评估量表均观察到统计学上显著的平均减少。根据Montgomery-Åsberg抑郁评定量表评分的变化，缓解率和缓解率分别为47.1%和64.7%。治疗耐受性良好，无意外或严重的不良事件。结论:本病例系列详细介绍了加速iTBS TMS方案的安全性和有效性，该方案由5天内25次治疗组成。观察到抑郁症状得到改善，缓解和缓解率与每日经颅磁刺激≥6周的标准经颅磁刺激方案相似。

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

Annals of Clinical Psychiatry PSYCHIATRY-

CiteScore

1.80

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： The ANNALS publishes up-to-date information regarding the diagnosis and /or treatment of persons with mental disorders. Preferred manuscripts are those that report the results of controlled clinical trials, timely and thorough evidence-based reviews, letters to the editor, and case reports that present new appraisals of pertinent clinical topics.