Motamed Mahtab, Fathi Azin, Hajikarim-Hamedani Arman, Alaghband-Rad Javad
Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.
Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
Ann Gen Psychiatry. 2025 May 19;24(1):30. doi: 10.1186/s12991-025-00572-y.
It is generally known that 30% of Major depressive disorder (MDD) patients do not respond to traditional pharmacological and psychosocial therapy. Transcranial magnetic stimulation (TMS), introduced first in 1985, was a non-invasive neural network research method. Later, repetitive Transcranial Magnetic Stimulation (rTMS) was approved by the FDA to treat treatment-resistant depression (TRD) in 2008. Over the past two decades, rTMS has been extensively developed using various protocols in order to stimulate superficial brain nerve cells non-invasively. We planned to see if high-frequency accelerated left prefrontal rTMS can improve symptoms of treatment resistant depression given its convenience it provides by having patients for fewer treatment sessions.
A total of 25 patients were enrolled in the study. Inclusion criteria were age between 18 and 60 and a history of at least one failed treatment with antidepressants. The treatment was conducted over six days scattered over three weeks and each day consisted of three 30-minute sessions (83, 83, and 84 trains for each session). The sessions were separated with 15-minute breaks. rTMS protocol: 120% of the motor threshold and frequency of 10 Hz. Consisting of 2.4 s trains with an intertrain interval of 15-seconds.
The study included 25 individuals (male: 12/13) with an average age of 36.88 ± 10.61. We compared outcome indicators at baseline and week three after confirming the normality of the data. After three weeks, Hamilton Depression Rating Scale and Clinician Global Impression showed a substantial improvement. There was a remission rate of 24% (6/25) and a response rate of 52% (13/25).
This work adds to the evidence that rTMS can treat TRD and shows that a more convenient high-frequency accelerated rTMS can improve symptoms in treatment resistant depression.
众所周知，30%的重度抑郁症（MDD）患者对传统药物和心理治疗无反应。经颅磁刺激（TMS）于1985年首次引入，是一种非侵入性神经网络研究方法。后来，重复经颅磁刺激（rTMS）于2008年被美国食品药品监督管理局（FDA）批准用于治疗难治性抑郁症（TRD）。在过去二十年中，rTMS已使用各种方案进行了广泛开发，以便非侵入性地刺激浅表脑神经细胞。鉴于高频加速左前额叶rTMS为患者提供了更少的治疗次数，从而具有便利性，我们计划研究其是否能改善难治性抑郁症的症状。
共有25名患者参与该研究。纳入标准为年龄在18至60岁之间且至少有一次抗抑郁药治疗失败史。治疗在三周内分散进行六天，每天包括三个30分钟的疗程（每个疗程分别为83、83和84串脉冲）。疗程之间间隔15分钟休息时间。rTMS方案：运动阈值的120%，频率为10赫兹。由2.4秒的串脉冲组成，串间间隔为15秒。
该研究纳入了25名个体（男性12名/女性13名），平均年龄为36.88±10.61。在确认数据呈正态分布后，我们比较了基线和第三周时的结果指标。三周后，汉密尔顿抑郁量表和临床医生整体印象显示有显著改善。缓解率为24%（6/25），有效率为52%（13/25）。
这项研究进一步证明了rTMS可治疗TRD，并表明更便捷的高频加速rTMS可改善难治性抑郁症的症状。
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