Transcranial Magnetic Stimulation TMS Effectiveness in studies

rTMS - Overview and evidence-based guidelines Depression Obsessive Compulsive Disorder (OCD) Anxiety Post-traumatic stress disorder (PTSD) Pain Stroke - motor disorders Stroke - Aphasia Multiple Sclerosis Abbreviations Training & Science Imprint neurocare group AG Albert-Einstein-Str. 3, 98693 Ilmenau, Germany Phone: +48 (3677) 68 979 0 E-mail: [email protected] • web: www.neurocaregroup.com Administrative Office: Rindermarkt 7 • 80331 Munich • Germany Images: neurocare group AG, Copyright: neurocare group AG 2020 The use or publication of contained text or images is strictly prohibited....

TMS: Overview - evidence-based guidelines Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018). Authors Lefaucheur JP, Aleman A, Baeken C, Benninger DH, Brunelin J, Di Lazzaro V, Filipovic SR, Grefkes C, Hasan A, Hummel FC, Jääskeläinen SK, Langguth B, Leocani L, Londero A, Nardone R, Nguyen JP, Nyffeler T, Oliveira-Maia AJ, Oliviero A, Padberg F, Palm U, Paulus W, Poulet E, Quartarone A, Rachid F, Rektorová I, Rossi S, Sahlsten H, Schecklmann M, Szekely D, Ziemann U Source Clinical Neurophysiology, 131 (2020), pp 474–528...

Depression Simultaneous rTMS and psychotherapy in major depressive disorder: Clinical outcomes and predictors from a large naturalistic study. Authors Donse L, Padberg F, Sack AT, Rush AJ, Arns M Objective evaluation of feasibility and clinical outcome of rTMS in combination with psychotherapy in major depressive disorder. Identification of clinical predictors of response and remission naturalistic study including 196 patients with depression, rTMS treatment with simultaneous psychotherapy. 97% had been unsuccessfully treated with medication at least once before. Protocol target area left DLPFC...

Results assessment response rate baseline 31.3 / Last session 14.1 / 55.9 % reduction, p < 0.001 DASS D DASS A DASS S baseline 28.6 / last session 12.1 baseline 13.7 / last session 5.6 baseline 22.4 / last session 10.1 BDI DASS depression DASS anxiety DASS stress baseline 29.4 / last session 8.0 / follow-up 13.8 baseline 27.0 / last session 6.5 / follow-up 11.8 baseline 14.1 / last session 4.0 / follow-up 7.2 baseline 22.3 / last session 7.3 / follow-up 12.5 Conclusions The combined therapy rTMS + psychotherapy led to high response and remission rates. In addition, the effect also showed good...

Depression Efficacy and Safety of Transcranial Magnetic Stimulation in the Acute Treatment of Major Depression: A Multisite Randomized Controlled Trial. Authors O’Reardon JP, Solvason HB, Janicak PG, Sampson S, Isenberg KE, Nahas Z, McDonald WM, Avery D, Fitzgerald PB, Loo C, Demitrack MA, George MS, Sackheim HA Objective effectiveness and safety of TMS over left DLPFC in the acute treatment of major depression Methodology double-blind, placebo-controlled study with 301 patients with depression (155 active rTMS, 146 placebo stimulation). Patients were medication-free and had shown medication...

Results assessment significance active vs. placebo active stimulation placebo stimulation MADRS response rate* MADRS remission rate** scalp discomfort/ pain reported as mild to moderate 35.8 %; diminished after first 5 sessions adverse events * 50 % improvement from baselinee. Conclusions TMS administered over the left DLPFC using the parameters reported here for a period of up to 6 weeks was effective in treating major depression with a good tolerability profile. These results indicate that rTMS offers clinicians a novel alternative in the treatment of this disorder.

Depression Efficacy of prefrontal theta-burst stimulation in refractory depression: a randomized placebo-controlled study. Authors Li CT, Chen MH, Juan CH, Huang HH, Chen LF, Hsieh JC, Tu PC, Bai YM, Tsai SJ, Lee YC, Su TP Objective antidepressant effect of right pre-frontal continuous, leftprefrontal intermittent and combined theta-burst stimulation compared to placebo group of patients showing different levels of antidepressant treatment resistance Methodology double-blind, placebo-controlled study with 60 patients with treatment-resistant depression (right-sided cTBS, left-sided iTBS, combined...

rate of change of HDRS scores right-sided cTBS left-sided iTBS placebo stimulation patients with moderate treatment resistance change in HDRS scores patients with high treatment resistance change in HDRS scores Conclusions Active theta-burst stimulation is safe, well-tolerated and effective in the treatment of therapy-resistant depression. The number of sessions needed for reduction in HDRS scores seems to be higher in case of greater treatment resistance. Left-sided iTBS and combined cTBS + iTBS are more effective than cTBS in highly refractory depression.

Obsessive-compulsive disorder (OCD) Repetitive transcranial magnetic stimulation in the treatment of obsessive-compulsive disorders: Double blind randomized clinical trial. Authors Elbeh KA, Elserogy YM, Khalifa HE, Ahmed MA, Hafez MH, Khedr EM Objective effectiveness of 1 Hz and 10 Hz rTMS compared to placebo in patients with OCD Methodology double-blind, placebo-controlled study with 45 patients (1 Hz, 10 Hz, placebo: 15 subjects per group) target area right DLPFC (5 cm rule) stim. frequency stim. intensity number of pulses per session every day, 5 time per week Y-BOCS, HAM-A, CGI-S

post-treatment 3 month follow-up post-treatment 3 month follow-up post-treatment 3 month follow-up placebo stimulation Conclusions 1 Hz rTMS over the right DLPFC shows significant reduction of OCD symptoms after 10 sessions. The improvement is evident in obsessions and compulsions as well as in anxiety. The effect was maintained in the follow-up after 3 months. In conclusion, low frequency rTMS over the right DLPFC is a promising tool for the treatment of OCD.

Anxiety Repetitive transcranial magnetic stimulation of the right dorsal lateral prefrontal cortex in the treatment of generalized anxiety disorder: A randomized, doubleblind placebo controlled clinical trial. Authors Dilkov D, Hawken ER, Kaludiev E, Milev R Prog Neuropsychopharmacol Biol Psychiatry 78 (2017) 61–65 Objective effectiveness of 20 Hz rTMS compared to placebo in patients with generalized anxiety disorder (GAD) Methodology single-blind, placebo-controlled study with 40 patients (15 active rTMS, 25 placebo stimulation) target area right DLPFC (5 cm rule) stim. frequency stim. intensity...