Evaluation of a 5 day accelerated 1 Hz repetitive transcranial magnetic stimulation protocol in major depression: A feasibility study

Jean-Philippe Miron; Molly Hyde; Linsay Fox; Jack Sheen; Helena Voetterl; Farrokh Mansouri; Véronique Desbeaumes Jodoin; Ryan Zhou; Sinjin Dees; Arsalan Mir-Moghtadaei; Daniel M. Blumberger; Zafiris J. Daskalakis; Fidel Vila-Rodriguez; Jonathan Downar

Journal of Affective Disorders Reports (Apr 2021)

Evaluation of a 5 day accelerated 1 Hz repetitive transcranial magnetic stimulation protocol in major depression: A feasibility study

Jean-Philippe Miron,
Molly Hyde,
Linsay Fox,
Jack Sheen,
Helena Voetterl,
Farrokh Mansouri,
Véronique Desbeaumes Jodoin,
Ryan Zhou,
Sinjin Dees,
Arsalan Mir-Moghtadaei,
Daniel M. Blumberger,
Zafiris J. Daskalakis,
Fidel Vila-Rodriguez,
Jonathan Downar

Affiliations

Jean-Philippe Miron: Krembil Research Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de Recherche du CHUM (CRCHUM), Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada; Corresponding author at: Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de Recherche du CHUM (CRCHUM), Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada.
Molly Hyde: Krembil Research Institute, University Health Network, Toronto, ON, Canada
Linsay Fox: Krembil Research Institute, University Health Network, Toronto, ON, Canada
Jack Sheen: Krembil Research Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Helena Voetterl: Krembil Research Institute, University Health Network, Toronto, ON, Canada; Department of Cognitive Neuroscience, Maastricht University, Maastricht, Limburg, the Netherlands
Farrokh Mansouri: Krembil Research Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Véronique Desbeaumes Jodoin: Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de Recherche du CHUM (CRCHUM), Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
Ryan Zhou: Krembil Research Institute, University Health Network, Toronto, ON, Canada
Sinjin Dees: Faculty of Engineering, McMaster University, Hamilton, ON, Canada
Arsalan Mir-Moghtadaei: Krembil Research Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Daniel M. Blumberger: Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention at the Centre for Addiction and Mental Health, Toronto, ON, Canada
Zafiris J. Daskalakis: Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention at the Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, San Diego, CA, USA
Fidel Vila-Rodriguez: Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
Jonathan Downar: Krembil Research Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

Journal volume & issue: Vol. 4
p. 100077

Abstract

Read online

Background: Repetitive transcranial magnetic stimulation (rTMS) is an effective intervention in major depressive disorder (MDD) but requires daily travel to a treatment clinic over several weeks. Shorter rTMS courses retaining similar effectiveness would thus increase the practicality and scalability of the technique, and therefore its accessibility. Objective: We assessed the feasibility of a novel 5 day accelerated 1 Hz rTMS protocol. We hypothesized that this novel rTMS protocol would be safe and well-tolerated while shortening the overall treatment course. Methods: We conducted a prospective, single-arm, open-label feasibility study. Thirty (30) participants received a one-week (5 days) accelerated (8 sessions per day, 40 sessions total) course of 1 Hz rTMS (600 pulses per session, 50-minute intersession interval) over the right dorsolateral prefrontal cortex (R-DLPFC) using a figure-of-eight coil at 120% of the resting motor threshold (rMT). Primary outcomes were response and remission rates on the Beck Depression Inventory-II (BDI-II). Results: Response and remission rates 1 week after treatment were 33.3% and 13.3% respectively and increased to 43.3% and 30.0% at follow-up 4 weeks after treatment. No serious adverse events occurred. All participants reported manageable pain levels. Conclusion: 1 Hz rTMS administered 8 times daily for 5 days is safe and well-tolerated. Validation in a randomized trial will be required. Trial registration: ClinicalTrials.gov Identifier: NCT04376697.

Published in Journal of Affective Disorders Reports

ISSN: 2666-9153 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Other systems of medicine: Mental healing
Website: https://www.journals.elsevier.com/journal-of-affective-disorders-reports

About the journal

Abstract

Keywords