“Transcranial Magnetic Stimulation (TMS)” is an extremely effective treatment for major depression that causes several adverse effects.

There have been several single-center studies that have enough evidences in support of the theory that TMS has antidepressant properties when applied to the left or right dorsolateral prefrontal cortex. However, each of these studies has one or other substantial limitation. These multifarious limitations depend upon particular anti depressant property of the TMS and may include insufficient treatment, poor design, and inadequate sample sizes.

John O’Reardon, from the “University of Pennsylvania in Philadelphia, USA”, and his colleague research scientists therefore conducted a multisite, double-blind study in 301 medication free patients with major depression who had not responded to previous therapy. They randomly assigned 155 patients to active “Transcranial Magnetic Stimulation (TMS)”and 146 to sham treatment. Findings of this research study were published recently in the journal “Biological Psychiatry”.

Report of this research study revealed that the active TMS patients were given 10 pulses per second, at 120% of the motor threshold, with 3000 pulses per session. The sessions were repeated five times per week continuously for 4-6 weeks. The symptom change score at week 4 on the “Montgomery-Åsberg Depression Rating Scale (MADRS)” was the primary outcome, while secondary outcomes included changes on the 17 and 24-item versions of the “Hamilton Depression Rating Scale (HAMD)”, and responses and remission rates on MADRS and HAMD.

Researchers found that the discontinuation rates in the active and sham TMS groups were similar, at 7.7% and 8.2%, respectively, and discontinuation due to adverse events was rare, at 4.5% and 3.4%, respectively. The most common adverse event causing discontinuation was scalp discomfort according to the study report.

Analysis of the study results revealed that there was a small, but significant, difference in MADRS total scores between the active and sham TMS groups at baseline, at 32.8 versus 33.9, respectively. After taking this into account, the team found that active TMS led to significant improvements in comparison with sham TMS on the MADRS at week 4, at average scores of 27.0 and 29.8, respectively.

The researchers’ team also found significant improvements with active TMS on the HAMD17 and HAMD24 scales at weeks 4 and 6, and response rates were significantly higher with active TMS on all three scales at weeks 4 and 6. In addition, active TMS improved remission rates at week 6 almost two-fold on the MADRS and HAMD24 scales, but not on the HAMD17 scale.

“In conclusion, TMS administered over the left dorsolateral prefrontal cortex using the parameters reported here for a period of up to 6 weeks was effective in treating major depression and with a good tolerability profile,” say the researchers in the journal “Biological Psychiatry”.

John O’Reardon, the lead researcher from the” University of Pennsylvania in Philadelphia, USA” remarked conclusively,  ”The results indicate that TMS offers clinicians a novel alternative to the treatment of this disorder”.

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