rTMS, Depression, OCD and Personalised Medicine
Key Studies which demonstrate the effects of rTMS / TMS as a treatment for Depression or OCD
Donse, Padberg, Sack, Rush & Arns (2017). Simultaneous rTMS and Psychotherapy in Major Depressive Disorder: Clinical Outcomes and Predictors from a Large Naturalistic Study. Brain Stimulation.
This study shows that combining rTMS with Psychotherapy (as per protocol in neuroCare Clinics) is more effective than either therapy alone. In this study of 196 patients, 66% of patients with Treatment Resistant Depression, responded after an average of 21 sessions. furthermore lasting effects are noticed after 6 months in 65% of this group. This suggests that the combined approach improves likelihood of a patient achieving complete remission.
Spronk, Arns & Fitzgerald (2010). repetitive Transcranial Magnetic Stimulation in Depression: Protocols, Mechanisms and New Developments. Neurofeedback and Neuromodulation Techniques and Applications (2011): 257.
A general book chapter providing a preliminary overview of rTMS as a treatment method for depression.
Arns, Drinkenburg, Fitzgerald & Kenemans (2012). Neurophysiological Predictors of Non-Response to rTMS in Depression. Brain Stimulation, 5(4), 569-576
This manuscript highlights some of the EEG predictors that are currently being further investigated, replicated and extended which can thereby facilitate the prediction of treatment outcomes of rTMS using baseline brain imaging data.
Donse, Sack, Fitzgerald & Arns (2017). Sleep Disturbances in Obsessive Compulsive Disorder: Association with Non-Response to repetitive Transcranial Magnetic Stimulation (rTMS). Journal of Anxiety Disorders, 49, 31 - 39 DOI:10.1016/J.JANXDIS.2017.03.0
The following study shows the first results of rTMS used in treatment resistant OCD where 55% of patients reponded to treatment. Furthermore, sleep onset problems were found as a reliable predictor for non-response to rTMS.
Arns et al. (2016). EEG Alpha Asymmetry as a Gender-Specific Predictor of Outcome to ACute Treatment with Different Antidepressant Medications in the Randomized iSPOT-D Study. Clinical Neurophysiology, 127(1), 509-519
The following reference provides results from a large multicentre study, to illustrate the potential of using EEG to predict treatment outcomes, which will become one of the major innovations in psychiatry in the years to come.
Iseger et al. (2017) Neuro-Cardiac-Guided TMS (NCG-TMS): Probining DLPFC-SGACC-VAGYS Nerve Connectivity Using Hear Rate - First Results. Brain Stimulation, HTTP://DX.DOI.ORG/10.1016/J.BRS.2017.05.002
First proof-of-concept study demonstrating a possible new way to localize the DLPFC using heart rate for rTMS treatment (Neuro-Cardiac-Guided TMS, NCG-TMS).
The following (external) references give further evidence on the efficacy of rTMS in the treatment of Depression & OCD
O'Reardon et al. (2007) Efficacy and Safety of Transcranial Magnetic Stimulation in the Acute Treatment of Major Depression: A Multisite Randomised Controlled Trial. Biology Psychiatry, 62(11), 1208 - 1216
The first randomized, multi-centre, double-blind placebo controlled study of rTMS in the treatment of depression that was pivotal in achieving FDA approval in the US for rTMS.
George et al. (2010) Daily Left Prefrontal Transcranial Magnetic Stimulation Therapy for Major Depressive Disorder: A Sham-Controlled Randomized Trial. Archives of General Psychiatry, 67(5), 507 - 516
An independent NIMH funded replication of the above multi-centre trial demonstrating efficacy of rTMS in the treatment of depression.
Schutter (2009) Antidepressant Efficacy of High-Frequency Transcranial Magnetic Stimulation over the Left Dorsolateral Prefrontal Cortex in Double-Blind-Sham-Controlled Designs: A Meta-Analysis. Psychological Medicine, 39(01), 65 - 75
A meta-analysis demonstrating efficacy of high-frequency rTMS in the treatment of depression.
Schutter (2010)Quantitative Review of the Efficacy of Slow-Frequency Magnetic Brain Stimulation in Major Depressive Disorder. Psychological Medicine, 40(11), 1789 - 1795
A meta-analysis demonstrating efficacy of low-frequency rTMS in the treatment of depression.
Carpenter et al. (2012) Transcranial Magnetic Stimulation (TMS) for Major Depression: A Multisite, Naturalistic, Observational Study of Acute Treatment Outcomes in Clinical Practice. Depression and Anxiety, 29(7), 587 - 596
This publication demonstrates the efficacy of a large multicentre naturalistic study demonstrating clinical efficacy in rTMS treatment of depression.
Dunner et al. (2014) A Multisite Naturalistic, Observational Study of Transcranial Magnetic Stimulation for Patients with Pharmacoresistant Major Depressive Disorder: Durability of Benefit Over a 1-Year Follow-Up Period. The Journal of Clinical Psychiatry, 75(12), 1394 - 1401
This publications presents the follow-up results from the above trial, demonstrating favourable long-term effects of rTMS over a 12 month time period.
Lefaucheur et al. (2014) Evidence-Based Guidelines on the Therapeutic Use of repetitive Transcranial Magnetic Stimulation (rTMS). Clinical Neurophysiology, 12511), 2150 - 2206
This paper presents a systematic review, meta-analyses and guidelines on the therapeutic use of rTMS by reviewing the evidence for many psychiatric and neurological indication suggesting level A and B evidence for treatment of depression, pain, Parkinsons and stroke.