Brain Stimulation最新文献

{"title":"Layer-specific electric fields and effective conductivity in nonhuman primates during transcranial electrical stimulation","authors":"Sangjun Lee ,&nbsp;Arnaud Falchier ,&nbsp;Alexander Opitz","doi":"10.1016/j.brs.2026.103060","DOIUrl":"10.1016/j.brs.2026.103060","url":null,"abstract":"<div><h3>Background</h3><div>Transcranial electrical stimulation (tES) is widely used to modulate brain activity in a safe and non-invasive manner. tES generates weak electric fields in cortical tissues, which can modulate membrane potential and alter the timing of neural spikes. These electric fields interact with cortical circuits in a layer-specific manner; however, the distribution of tES-generated electric fields across cortical layers remains poorly understood. Because cortical layers differ in cytoarchitecture, electric fields are likely not uniform and may differ across layers. However, direct in vivo evidence of layer-specific TES electric fields is still lacking.</div></div><div><h3>Methods</h3><div>We conducted laminar recordings in the visual cortex of two nonhuman primates (NHPs) during low-frequency transcranial alternating current stimulation to capture layer-specific electric fields. To estimate layer-specific effective electrical conductivity, we compared these in vivo measurements with electric fields from finite element method (FEM) simulations. We first constructed a simplified sandwich model matching the dimensions of the laminar setup. Building on this, we then created a realistic multi-layer FEM head model of the NHP and optimized the effective conductivity of individual cortical layers by minimizing the error between measured and simulated electric fields.</div></div><div><h3>Results</h3><div>Repeated laminar recordings showed inhomogeneous electric fields across cortical layers, with a peak in electric field strength in layers 2/3 followed by a gradual decrease toward the white matter in both NHPs. Accordingly, optimization produced non-uniform conductivity values across layers, with the lowest conductivity in layers 2/3 and relatively higher values in white matter compared to commonly used reference values.</div></div><div><h3>Conclusion</h3><div>Our findings provide direct in vivo evidence for layer-specific electric fields and effective electrical conductivity at the mesoscale in the primate cortex, emphasizing the importance of considering laminar cortical organization. This work advances the fundamental understanding of how externally applied currents interact with the brain and provides a basis for more accurate computational models and clinically relevant neuromodulation strategies.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103060"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"fMRI-based deep brain stimulation programming for Parkinson's disease: a blinded, crossover clinical trial","authors":"Brendan Santyr ,&nbsp;Alexandre Boutet ,&nbsp;Jürgen Germann ,&nbsp;Jianwei Qiu ,&nbsp;Aaron Loh ,&nbsp;Ibrahim Alhashyan ,&nbsp;Clement T. Chow ,&nbsp;Can Sarica ,&nbsp;Artur Vetkas ,&nbsp;Andrew Z. Yang ,&nbsp;Gavin J.B. Elias ,&nbsp;Stefan Lang ,&nbsp;Mojgan Hodaie ,&nbsp;Suneil K. Kalia ,&nbsp;Alfonso Fasano ,&nbsp;Afis Ajala ,&nbsp;Andres M. Lozano","doi":"10.1016/j.brs.2026.103069","DOIUrl":"10.1016/j.brs.2026.103069","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103069"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic rodent-to-human approximation of the mesencephalic cuneiform nucleus to guide deep brain stimulation","authors":"Anna-Sophie Hofer ,&nbsp;Myriam Ilona Scheuber ,&nbsp;Andrea Michele Sartori ,&nbsp;Ivo Skorup ,&nbsp;Dominic Gascho ,&nbsp;Giovanni Colacicco ,&nbsp;Alina Kiseleva ,&nbsp;Armin Curt ,&nbsp;Lennart Henning Stieglitz ,&nbsp;Martin Ernst Schwab","doi":"10.1016/j.brs.2026.103066","DOIUrl":"10.1016/j.brs.2026.103066","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Permanent gait dysfunction is common after severe spinal cord injury. It is attributed to insufficient excitation and control of sublesional spinal locomotor centers due to disrupted descending input. Deep brain stimulation of the cuneiform nucleus has emerged as a promising approach to restore locomotion in individuals with incomplete lesions. It increases reticulospinal drive and was shown to improve gait in preclinical rodent models of spinal cord injury. Early human trials are underway (&lt;span&gt;&lt;span&gt;clinicaltrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, NCT03053791, NCT07109804). The cuneiform nucleus and the pedunculopontine nucleus form the mesencephalic locomotor region, a gait control center evolutionarily conserved across species. Given the proximity to several other critical brainstem structures, precise placement of stimulation electrodes is essential. Yet, empirical human data on optimal stimulation sites in this novel target are scarce.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The study aimed to translate the stereotactic localization of the functionally relevant area of the rodent cuneiform nucleus to application in humans considering the brainstem's phylogenetic conservation across vertebrate species. The overall goal was to provide heuristically derived, orientational coordinates and landmarks to guide human electrode implantation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;First, the key functional area of the rat cuneiform nucleus was confirmed by electrical mapping, and the anatomical sites of the rodent (rat and mouse) cuneiform and pedunculopontine nuclei were delineated by &lt;em&gt;in situ&lt;/em&gt; hybridization for mRNA of the respective markers neurotensin and choline acetyltransferase. Labeled cell distributions were reconstructed in a stereotactic coordinate system. Anatomical landmarks to localize the cuneiform nucleus and their relative spatial relationships were then applied to the human brainstem, also considering published stimulation sites of individuals who previously underwent stimulation of the cuneiform or pedunculopontine nucleus. Stereotactic targeting of the cuneiform nucleus was simulated on &lt;em&gt;postmortem&lt;/em&gt; magnetic resonance scans of human brains and stereotactic coordinates were extracted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Cross-species evaluation enabled derivation of an anatomy-anchored estimate of implantation coordinates for deep brain stimulation of the human cuneiform nucleus. Comparison with the electrode locations of previously implanted individuals informed refinement of target specification for future patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study provides heuristic coordinates to target the cuneiform nucleus for deep brain stimulation. Given that localization of the human cuneiform nucleus was only indirect and that cross-species translation of coordinates is inherently approximate, the proposed coordinates and landmarks should be regarded as guidance. They do","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103066"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated TMS with the H1-coil for depression: A multisite, randomized non-inferiority trial","authors":"Colleen A. Hanlon ,&nbsp;Yiftach Roth ,&nbsp;Richard A. Bermudes ,&nbsp;Eliza Brink ,&nbsp;Molly Davis ,&nbsp;Dawn DeBrocco ,&nbsp;Shelli Ellis ,&nbsp;Lindsey Jones ,&nbsp;Aftab Khan ,&nbsp;Carlene McMillan ,&nbsp;Aswin Kumar Mudunuru ,&nbsp;Owen Muir ,&nbsp;Gabriel S. Pell ,&nbsp;Timothy Prestley ,&nbsp;M.S. Reddy ,&nbsp;Adi Rachelson ,&nbsp;Elyssa Sisko ,&nbsp;Samson Seplow ,&nbsp;Natanya Slomowitz ,&nbsp;Ahava Stein ,&nbsp;Aron Tendler","doi":"10.1016/j.brs.2026.103050","DOIUrl":"10.1016/j.brs.2026.103050","url":null,"abstract":"<div><h3>Background</h3><div>Transcranial magnetic stimulation with the H1-coil is an FDA-cleared treatment for major depressive disorder (MDD), traditionally delivered once daily over six weeks. Accelerated protocols condense treatment by administering multiple sessions per day. This multisite, randomized, blinded non-inferiority trial compared a five-times-daily accelerated intermittent theta burst stimulation (ACC-iTBS) protocol with the standard of care high-frequency (SOC-HF) H1 coil TMS protocol in adults with MDD.</div></div><div><h3>Methods</h3><div>104 adults with moderate-to-severe MDD were randomized to: (1) ACC-iTBS (110%rMT, H1 coil): 5 sessions/day for 6 days (30 sessions) over 2 weeks, plus 2 sessions/day one day/week for 4 weeks (8 sessions); or (2) SOC-HF (120%rMT, H1 coil): once-daily sessions for 4 weeks (20 sessions), followed by 2 sessions/week for 2 weeks (4 sessions). The primary endpoint was change in HDRS-21 score at week 6. Secondary outcomes included response, remission, anxiety, and adverse events.</div></div><div><h3>Results</h3><div>89 participants completed the 6-week study enrollment (ACC-iTBS: 41; SOC-HF: 48). Both groups showed significant HDRS-21 improvement at week 6 (ACC-iTBS: −19.02 points; SOC-HF: −19.79; p &lt; 0.001), with a non-significant between-group difference (0.76, p = 0.78), and upper limit of the one-sided 97.5% CI was 2.73 (&lt; inferiority margin δ = 3.0 points on the HDRS-21). ACC-iTBS showed faster symptom reduction by week 2 (median HDRS change: −11.70 vs. −8.590) and shorter time to remission (21 vs. 28 days; p = 0.0324). Week 6 response/remission rates were 87.8%/78.0% (ACC-iTBS) and 87.5%/87.5% (SOC-HF). Anxiety also improved in both groups. Adverse events, including treatment-site discomfort and headaches, were more common with ACC-iTBS. Blinding was preserved.</div></div><div><h3>Conclusions</h3><div>ACC-iTBS TMS with the H1 coil is a safe, well-tolerated, and time-efficient alternative to standard HF H1-coil TMS, offering comparable outcomes and faster remission.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103050"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma tACS as a novel treatment for primary progressive aphasia: A pilot case series of four cases","authors":"Vertti Etelämäki ,&nbsp;Laura Säisänen ,&nbsp;Sara Määttä ,&nbsp;Jelena Hyppönen ,&nbsp;Noora-Maria Suhonen ,&nbsp;Johanna Krüger ,&nbsp;Annakaisa Haapasalo ,&nbsp;Barbara Borroni ,&nbsp;Esa Mervaala ,&nbsp;Kasper Katisko ,&nbsp;Eino Solje","doi":"10.1016/j.brs.2026.103046","DOIUrl":"10.1016/j.brs.2026.103046","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103046"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing naturalistic brain stimulation targeting aperiodic EEG features: Transcranial endogenous current stimulation (tECS)","authors":"Athena Stein ,&nbsp;Ellen Floegel ,&nbsp;Mengsen Zhang ,&nbsp;Akshada Subramaniyan ,&nbsp;Swarup Sharma ,&nbsp;Zachary Feldman ,&nbsp;Michael Evers ,&nbsp;Julia Riddle ,&nbsp;Samantha Meltzer-Brody ,&nbsp;Flavio Frohlich","doi":"10.1016/j.brs.2026.103036","DOIUrl":"10.1016/j.brs.2026.103036","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103036"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vital-affective symptom connectivity during electroconvulsive therapy distinguishes depression remission outcomes: A cross-lagged panel network study","authors":"Melissa G. Zandstra ,&nbsp;Gabriela Lunansky ,&nbsp;Floortje E. Scheepers ,&nbsp;Tessa F. Blanken ,&nbsp;Tom K. Birkenhager ,&nbsp;Dieneke Bloemkolk ,&nbsp;Birit F.P. Broekman ,&nbsp;Philip van Eijndhoven ,&nbsp;Eric van Exel ,&nbsp;Frank L. Gerritse ,&nbsp;Johanna M. Hegeman ,&nbsp;Willemijn Heijnen ,&nbsp;Rob M. Kok ,&nbsp;Dore Loef ,&nbsp;Roel J.T. Mocking ,&nbsp;Jasper O. Nuninga ,&nbsp;Mardien L. Oudega ,&nbsp;Didi Rhebergen ,&nbsp;Henricus G. Ruhe ,&nbsp;Bart P.F. Rutten ,&nbsp;Metten Somers","doi":"10.1016/j.brs.2026.103058","DOIUrl":"10.1016/j.brs.2026.103058","url":null,"abstract":"<div><h3>Background</h3><div>Electroconvulsive therapy (ECT) is effective for depression, but symptom dynamics during treatment remain unclear. Network approaches may clarify symptom relations and identify patterns linked to remission.</div></div><div><h3>Objective</h3><div>Examining symptom dynamics during ECT using temporal network modeling and comparing baseline and temporal symptom networks between remitters and non-remitters.</div></div><div><h3>Methods</h3><div>Using the Dutch ECT Consortium (N = 857, unipolar/bipolar depression), we examined seven harmonized symptoms from the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery–Åsberg Depression Rating Scale (MADRS) over the first five weeks of treatment. We estimated baseline networks using partial correlations and temporal networks using Cross-Lagged Panel Network analysis, which quantified each symptom's in-prediction and out-prediction. Between remitters (N = 413) and non-remitters (N = 379), baseline networks were compared using the Network Comparison Test, while temporal networks were compared via network density, Jaccard overlap, and edge correlations.</div></div><div><h3>Results</h3><div>In the full sample (65.2% female, mean age 61.3 ± 15.5 years), suicidal thoughts exerted the strongest influence on other symptoms (i.e., highest out-prediction). Baseline networks did not differ by outcome, but temporal networks did: remitters showed greater density than non-remitters (χ² = 8.20, p &lt; 0.01), with low overlap in edges (Jaccard = 0.25), and non-significant edge-weight correlations (r = 0.16; p = 0.46) between groups. Remitters displayed integrated affective-vital symptom connections, while non-remitters showed fragmented subnetworks.</div></div><div><h3>Conclusions</h3><div>Reductions in suicidal thoughts preceded broader symptom improvements, suggesting this symptom warrants monitoring. Remitters showed coordinated symptom reduction where affective and vital symptoms reinforced each other, while non-remitters showed independent reduction. These findings provide insights into symptom dynamics during ECT.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103058"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated rTMS: Complexities and clinical translation","authors":"Paul B. Fitzgerald ,&nbsp;Jim Lagopoulos ,&nbsp;Xianwei Che","doi":"10.1016/j.brs.2026.103057","DOIUrl":"10.1016/j.brs.2026.103057","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103057"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal interference stimulation for treating prolonged disorders of consciousness: A pilot study","authors":"Bohan Zhu ,&nbsp;Ziying Ye ,&nbsp;Yinan Ai ,&nbsp;Shaoping Wu ,&nbsp;Xiangfeng Chi ,&nbsp;Hannan Cai ,&nbsp;Guojian Chen ,&nbsp;Yuang Zheng ,&nbsp;Qilin Cheng ,&nbsp;Fang Zheng ,&nbsp;Lili Li ,&nbsp;Haiqing Zheng ,&nbsp;Mingyu Yin ,&nbsp;Liying Zhang ,&nbsp;Xiquan Hu","doi":"10.1016/j.brs.2026.103047","DOIUrl":"10.1016/j.brs.2026.103047","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103047"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes following accelerated vs. standard TMS with the H1 coil for major depression: A multisite randomized trial","authors":"Aron Tendler ,&nbsp;Yiftach Roth ,&nbsp;Mallory Bates ,&nbsp;Eliza Brink ,&nbsp;Molly Davis ,&nbsp;Dawn DeBrocco ,&nbsp;Shelli Ellis ,&nbsp;Lindsey Jones ,&nbsp;Aftab Khan ,&nbsp;Spencer Luce ,&nbsp;Carlene McMillan ,&nbsp;Aswin Kumar Mudunuru ,&nbsp;Owen Muir ,&nbsp;Gabriel S. Pell ,&nbsp;Timothy Prestley ,&nbsp;M.S. Reddy ,&nbsp;Noelia Rodriguez ,&nbsp;Samson Seplow ,&nbsp;Natanya Slomowitz ,&nbsp;Ahava Stein ,&nbsp;Colleen A. Hanlon","doi":"10.1016/j.brs.2026.103048","DOIUrl":"10.1016/j.brs.2026.103048","url":null,"abstract":"<div><h3>Objective</h3><div>Clinician-rated measures remain the gold standard in depression trials, but patient-reported outcomes (PROs) provide essential insights into real-world experiences. This study compared PROs in patients with Major Depressive Disorder (MDD) receiving either accelerated H1-coil Transcranial Magnetic Stimulation (ACC-iTBS) or standard once-daily high-frequency H1-coil TMS (SOC-HF).</div></div><div><h3>Methods</h3><div>In this randomized, multisite trial, 104 adults with moderate-to-severe MDD were assigned to ACC-iTBS (five sessions/day for six days, 50min intersession-interval, 50 Hz triplets, 5 Hz bursts frequency, 2s on, 8s off, 1800 pulses/session) or SOC-HF (daily sessions for four weeks, 18 Hz, 2s on 20s off, 1980 pulses/session), each followed by continuation treatment through week 6. PROs included the daily Clinically Useful Depression Outcome Scale (CUDOS-D), Clinically Useful Anxiety Outcome Scale (CUXOS-D), and the Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Outcomes assessed were response/remission rates, time to perceived improvement, and quality-of-life changes.</div></div><div><h3>Results</h3><div>Both protocols produced significant and comparable improvements in depressive symptoms, anxiety, and quality-of-life. Week 6 CUDOS response/remission rates were 70.0%/57.5% (ACC-iTBS) and 75.6%/58.5% (SOC-HF); CUXOS rates were 70.0%/67.5% (ACC-iTBS) and 75.6%/69.0% (SOC-HF). Patients in the ACC-iTBS arm reported a shorter median time to CUDOS response (11 vs. 16 days, p = 0.0377). Anxiety improvements emerged early and were sustained across both groups. By week 6, severe quality-of-life impairment declined to 15–17%, compared with 85–100% at baseline. No significant between-group differences were observed.</div></div><div><h3>Conclusions</h3><div>Accelerated TMS with the H1 coil provides patient-perceived benefits comparable to standard treatment while delivering faster relief of depressive symptoms. ACC-iTBS may represent a time-efficient, patient-centered alternative that improves accessibility and satisfaction for individuals with MDD.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 2","pages":"Article 103048"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}