Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan-Feb;14(1):173-180.
doi: 10.1016/j.brs.2020.12.003. Epub 2020 Dec 17.

Comparison of clinical outcomes with two Transcranial Magnetic Stimulation treatment protocols for major depressive disorder

LindaL Carpenter  1 , ScottT Aaronson  2 , Todd M Hutton  3 , Miriam Mina  4 , Kenneth Pages  5 , Sarah Verdoliva  6 , W Scott West  7 , HaroldA Sackeim  8
Affiliations
Free article

Comparison of clinical outcomes with two Transcranial Magnetic Stimulation treatment protocols for major depressive disorder

LindaL Carpenter et al. Brain Stimul. 2021 Jan-Feb.
Free article

Abstract

Background: Transcranial magnetic stimulation (TMS) is an effective treatment for major depressive disorder (MDD). The rest time between pulse trains is the inter-train interval (ITI). Since 2016, some TMS clinicians have adopted a stimulation protocol with shorter ITIs than were used in regulatory clinical trials.

Objective: To contrast treatment outcomes with the Standard TMS protocol (38.5 min per session) and the "Dash" protocol, which, at the shortest ITI, has a session duration of 18.75 min.

Methods: Registry data were collected at 103 practice sites. Of 7759 participants, 5010 were included in an intent-to-treat (ITT) sample, defined as a primary MDD diagnosis, age ≥ 18, and completion of the PHQ-9 before TMS and with at least one PHQ-9 assessment after baseline. Completers (N = 3814) were responders or had received ≥ 20 sessions and had an end of acute treatment PHQ-9 assessment. Within the ITT sample, 613 patients were treated with the Standard NeuroStar 38-min protocol and 1493 patients with the new Dash protocol. CGI-S ratings were obtained in smaller samples. Treatment outcomes were also examined in subgroups considered Completers, as well as the subgroups who met criteria for Full Adherence to the Standard or Dash protocol parameters.

Results: In the ITT, Completer, and Fully Adherent samples, response (58-72%) and remission (28-53%) rates were notably high across PHQ-9 and CGI-S ratings. The Standard and Dash protocols did not differ in number of treatment sessions, and both manifested strong antidepressant effects.

Conclusions: The Standard and Dash protocols did not meaningfully differ in efficacy.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest Dr. Carpenter serves as a scientific advisor to Neuronetics Inc, Nexstim PLC, Affect Neuro Inc, Neurolief LTD, Sage Therapeutics, and Janssen Pharmaceuticals Inc. Dr. Carpenter has received research support (to Butler Hospital) from Neuronetics Inc, Neosync Inc, Nexstim PLC, Affect Neuro Inc, and Janssen Pharmaceuticals Inc. Dr. Aaronson serves as a scientific adviser to Genomind Inc, LivaNova PLC, Neuronetics Inc, Janssen Pharmaceuticals Inc, and Sage Therapeutics and has received research support from Compass Pathways Inc and Neuronetics Inc. He is a member of the Speaker Bureau for Sunovion Pharmaceuticals Inc. and Janssen Pharmaceuticals Inc. Drs. Hutton, Pages, and West serve as consultants to Neuronetics, Inc. and Ms. Mina is an employee of Neuronetics, Inc. Ms. Verdoliva reports no financial relationship with commercial interests. Dr. Sackeim serves as a scientific adviser to Cerebral Therapeutics Inc., LivaNova PLC, MECTA Corporation, and Neuronetics Inc. He receives honoraria and royalties from Elsevier Inc. and Oxford University Press. He is the inventor on non-remunerative US patents for Focal Electrically-Administered Seizure Therapy (FEAST), titration in the current domain in ECT, and the adjustment of current in ECT devices, each held by the MECTA Corporation. He is also the originator of magnetic seizure therapy (MST). Collection of registry data and statistical analyses for this study were funded by Neuronetics Inc.

Publication types

LinkOut - more resources