Introduction: Repetitive Transcranial Magnetic Stimulation (rTMS) has demonstrated both safety and efficacy in the treatment of Depressive Episodes but requires daily treatment over 4-6 weeks. Accelerated TMS (aTMS), which delivers all treatments within a few days, offers potential advantages in improving accessibility and enhancing patient adherence. Methods: In order to evaluate the effectiveness of aTMS compared to regular daily rTMS, 33 inpatients affected by Major Depressive Episodes treated with either Fluvoxamine or Venlafaxine were enrolled. Patients were randomly assigned to the two protocol groups: standard rTMS group (15 patients) and aTMS group (18 patients). In the standard protocol, patients received 1 rTMS session/day for 4 weeks, while in the aTMS protocol they received 4 rTMS sessions/day for 5 days. Symptomatological improvement was evaluated through MADRS, BDI-II and SSI rating scales. The study was single-blind. Response and remission rates were calculated, defined respectively as a reduction ≥ 50 % in the MADRS score and a MADRS score < 10. Results: The analysis was carried out on 31 patients (18 in the aTMS group and 13 in the rTMS group). The aTMS and rTMS response rates were respectively 72 % vs. 38.5 % on day 28 (p = 0.040) and 83.3 % vs. 38.5 % on day 56 (p = 0.011). The aTMS and rTMS group remission rates were respectively 67 % vs. 15.4 % on day 28 (p = 0.0001) and 61 % vs. 30,8 % on day 56 (p = 0.006). Concerning side effects, no statistically significant differences were observed between the two groups. Conclusions: Treatment with aTMS seems faster and more effective than treatment with standard rTMS in improving the clinical condition in patients with Major Depressive Episodes, allowing to treat patients in just 5 days instead of 4 weeks, without impacting on side effects and tolerability.
Accelerated repetitive Transcranial Magnetic Stimulation (aTMS) vs. standard repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of Major Depressive Episodes: A randomized, single-blind, controlled trial / Prato, M., Seghi, F., Barbini, B., Ragone, N., Passani, C., Colombo, C.. - In: TRANSCRANIAL MAGNETIC STIMULATION. - ISSN 3050-5291. - 4:(2025). [10.1016/j.transm.2025.100177]
Accelerated repetitive Transcranial Magnetic Stimulation (aTMS) vs. standard repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of Major Depressive Episodes: A randomized, single-blind, controlled trial
Prato, MichelePrimo
;Seghi, Federico;Ragone, Nicola;Passani, Carolina;Colombo, Cristina
2025-01-01
Abstract
Introduction: Repetitive Transcranial Magnetic Stimulation (rTMS) has demonstrated both safety and efficacy in the treatment of Depressive Episodes but requires daily treatment over 4-6 weeks. Accelerated TMS (aTMS), which delivers all treatments within a few days, offers potential advantages in improving accessibility and enhancing patient adherence. Methods: In order to evaluate the effectiveness of aTMS compared to regular daily rTMS, 33 inpatients affected by Major Depressive Episodes treated with either Fluvoxamine or Venlafaxine were enrolled. Patients were randomly assigned to the two protocol groups: standard rTMS group (15 patients) and aTMS group (18 patients). In the standard protocol, patients received 1 rTMS session/day for 4 weeks, while in the aTMS protocol they received 4 rTMS sessions/day for 5 days. Symptomatological improvement was evaluated through MADRS, BDI-II and SSI rating scales. The study was single-blind. Response and remission rates were calculated, defined respectively as a reduction ≥ 50 % in the MADRS score and a MADRS score < 10. Results: The analysis was carried out on 31 patients (18 in the aTMS group and 13 in the rTMS group). The aTMS and rTMS response rates were respectively 72 % vs. 38.5 % on day 28 (p = 0.040) and 83.3 % vs. 38.5 % on day 56 (p = 0.011). The aTMS and rTMS group remission rates were respectively 67 % vs. 15.4 % on day 28 (p = 0.0001) and 61 % vs. 30,8 % on day 56 (p = 0.006). Concerning side effects, no statistically significant differences were observed between the two groups. Conclusions: Treatment with aTMS seems faster and more effective than treatment with standard rTMS in improving the clinical condition in patients with Major Depressive Episodes, allowing to treat patients in just 5 days instead of 4 weeks, without impacting on side effects and tolerability.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
