School of Medicine, Flinders University, Adelaide, SA, Australia.
The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, Adelaide, SA, Australia.
J Affect Disord. 2021 Mar 1;282:974-978. doi: 10.1016/j.jad.2021.01.009. Epub 2021 Jan 7.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a safe and effective treatment for treatment resistant depression (TRD). The number of patients able to be treated with rTMS is determined by the availability of the machine and staff. If treatment delivered in a shorter time were just as effective as longer treatments, then more patients could be treated with the same resources.
This naturalistic study investigated 145 first-time patients treated with 15 minute (900 pulses) or 30 minute (1800 pulses) RLF rTMS for TRD 3 days/week for 6 weeks. Response and remission rates for the two groups were compared. We investigated whether longer right unilateral low (1Hz) frequency (RLF) repetitive transcranial magnetic stimulation (rTMS) treatment sessions are more effective than shorter sessions in achieving response and remission for treatment resistant depression (TRD).
The duration of rTMS treatment sessions had no effect on treatment outcomes over the course of 6 weeks. The group treated with 15 minute rTMS sessions showed a partial response rate of 28.2%, a response rate of 11.5% and remission rate of 21.8%, which did not differ significantly from patients receiving 30 minute sessions who had a partial response rate of 25.4%, response rate of 17.9% and remission rate of 22.4%.
Participants were not randomized and the inclusion criteria were broad and reflected the nature of patients seen in routine practice.
Fifteen minute rTMS sessions 3 days/week for 6 weeks were as effective as 30 minute sessions, providing a pragmatic advantage for shorter treatments.
重复经颅磁刺激（rTMS）是治疗难治性抑郁症（TRD）的一种安全有效的方法。能够接受 rTMS 治疗的患者数量取决于机器和人员的可用性。如果在更短的时间内进行治疗同样有效，那么可以使用相同的资源治疗更多的患者。
本自然研究调查了 145 名首次接受 15 分钟（900 脉冲）或 30 分钟（1800 脉冲）RLF rTMS 治疗的 TRD 患者，每周 3 天，6 周。比较两组的反应率和缓解率。我们研究了更长时间的右侧单侧低频（1Hz）重复经颅磁刺激（rTMS）治疗是否比较短时间的治疗更有效，以达到治疗难治性抑郁症（TRD）的反应和缓解。
在 6 周的治疗过程中，rTMS 治疗时间的长短对治疗结果没有影响。接受 15 分钟 rTMS 治疗的患者部分缓解率为 28.2%，有效率为 11.5%，缓解率为 21.8%，与接受 30 分钟治疗的患者（部分缓解率为 25.4%，有效率为 17.9%，缓解率为 22.4%）无显著差异。
参与者未随机分组，纳入标准广泛，反映了常规实践中患者的特点。
每周 3 天，6 周内进行 15 分钟 rTMS 治疗与 30 分钟治疗同样有效，为缩短治疗时间提供了实际优势。
