Feasibility and clinical effects of theta burst stimulation in youth with major depressive disorders: An open-label trial

Prabhjot Dhami, Yuliya Knyahnytska, Sravya Atluri, Jonathan Lee, Darren B. Courtney, Paul E. Croarkin, Daniel M. Blumberger, Zafiris J. Daskalakis, Faranak Farzan

Research output: Contribution to journalArticle

Abstract

Background: Conventional treatments for youth depression, such as antidepressants, have modest efficacy, side effects, and ongoing controversies regarding safety. Repetitive transcranial magnetic stimulation (rTMS), specifically theta burst stimulation (TBS), applied to the dorsolateral prefrontal cortex (DLPFC) has demonstrated efficacy for the treatment of depression in adults. However, the feasibility and clinical response to TBS for youth depression has yet to be explored. Methods: Twenty participants between the ages of 16 to 24 years old with MDD were recruited. The intervention consisted of 10 treatment sessions over the course of two weeks, in which participants received intermittent TBS and continuous TBS stimulation to the left and right DLPFC, respectively. Change in the Hamilton Rating Scale for Depression (HRSD-17) score was the primary outcome. Clinical assessments occurred at baseline, after the fifth treatment session, and within a week after treatment completion. Results: Of the twenty participants, eighteen received all TBS sessions, and seventeen completed all clinical assessments. There was a significant reduction in depressive symptoms following treatment completion (p < 0.001). Four of the twenty patients had more than 50% reduction in their depressive symptoms, two of whom achieved remission. All participants received and tolerated at least six daily TBS treatments with no major adverse events. Limitations: Study was an uncontrolled, open-label design. Conclusion: Ten sessions of TBS was feasible, well tolerated, and appeared to have clinical effects for the treatment of depressed youth. Future sham-controlled randomized trials are warranted to validate these findings in a larger cohort of youth depression.

Original languageEnglish (US)
Pages (from-to)66-73
Number of pages8
JournalJournal of Affective Disorders
Volume258
DOIs
StatePublished - Nov 1 2019

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Major Depressive Disorder
Depression
Prefrontal Cortex
Therapeutics
Transcranial Magnetic Stimulation
Antidepressive Agents
Randomized Controlled Trials
Safety

Keywords

  • Adolescence
  • Major Depressive Disorder (MDD)
  • Repetitive Transcranial Magnetic Stimulation (rTMS)
  • Theta Burst Stimulation (TBS)
  • Youth

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Feasibility and clinical effects of theta burst stimulation in youth with major depressive disorders : An open-label trial. / Dhami, Prabhjot; Knyahnytska, Yuliya; Atluri, Sravya; Lee, Jonathan; Courtney, Darren B.; Croarkin, Paul E.; Blumberger, Daniel M.; Daskalakis, Zafiris J.; Farzan, Faranak.

In: Journal of Affective Disorders, Vol. 258, 01.11.2019, p. 66-73.

Research output: Contribution to journalArticle

Dhami, Prabhjot ; Knyahnytska, Yuliya ; Atluri, Sravya ; Lee, Jonathan ; Courtney, Darren B. ; Croarkin, Paul E. ; Blumberger, Daniel M. ; Daskalakis, Zafiris J. ; Farzan, Faranak. / Feasibility and clinical effects of theta burst stimulation in youth with major depressive disorders : An open-label trial. In: Journal of Affective Disorders. 2019 ; Vol. 258. pp. 66-73.
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abstract = "Background: Conventional treatments for youth depression, such as antidepressants, have modest efficacy, side effects, and ongoing controversies regarding safety. Repetitive transcranial magnetic stimulation (rTMS), specifically theta burst stimulation (TBS), applied to the dorsolateral prefrontal cortex (DLPFC) has demonstrated efficacy for the treatment of depression in adults. However, the feasibility and clinical response to TBS for youth depression has yet to be explored. Methods: Twenty participants between the ages of 16 to 24 years old with MDD were recruited. The intervention consisted of 10 treatment sessions over the course of two weeks, in which participants received intermittent TBS and continuous TBS stimulation to the left and right DLPFC, respectively. Change in the Hamilton Rating Scale for Depression (HRSD-17) score was the primary outcome. Clinical assessments occurred at baseline, after the fifth treatment session, and within a week after treatment completion. Results: Of the twenty participants, eighteen received all TBS sessions, and seventeen completed all clinical assessments. There was a significant reduction in depressive symptoms following treatment completion (p < 0.001). Four of the twenty patients had more than 50{\%} reduction in their depressive symptoms, two of whom achieved remission. All participants received and tolerated at least six daily TBS treatments with no major adverse events. Limitations: Study was an uncontrolled, open-label design. Conclusion: Ten sessions of TBS was feasible, well tolerated, and appeared to have clinical effects for the treatment of depressed youth. Future sham-controlled randomized trials are warranted to validate these findings in a larger cohort of youth depression.",
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T2 - An open-label trial

AU - Dhami, Prabhjot

AU - Knyahnytska, Yuliya

AU - Atluri, Sravya

AU - Lee, Jonathan

AU - Courtney, Darren B.

AU - Croarkin, Paul E.

AU - Blumberger, Daniel M.

AU - Daskalakis, Zafiris J.

AU - Farzan, Faranak

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N2 - Background: Conventional treatments for youth depression, such as antidepressants, have modest efficacy, side effects, and ongoing controversies regarding safety. Repetitive transcranial magnetic stimulation (rTMS), specifically theta burst stimulation (TBS), applied to the dorsolateral prefrontal cortex (DLPFC) has demonstrated efficacy for the treatment of depression in adults. However, the feasibility and clinical response to TBS for youth depression has yet to be explored. Methods: Twenty participants between the ages of 16 to 24 years old with MDD were recruited. The intervention consisted of 10 treatment sessions over the course of two weeks, in which participants received intermittent TBS and continuous TBS stimulation to the left and right DLPFC, respectively. Change in the Hamilton Rating Scale for Depression (HRSD-17) score was the primary outcome. Clinical assessments occurred at baseline, after the fifth treatment session, and within a week after treatment completion. Results: Of the twenty participants, eighteen received all TBS sessions, and seventeen completed all clinical assessments. There was a significant reduction in depressive symptoms following treatment completion (p < 0.001). Four of the twenty patients had more than 50% reduction in their depressive symptoms, two of whom achieved remission. All participants received and tolerated at least six daily TBS treatments with no major adverse events. Limitations: Study was an uncontrolled, open-label design. Conclusion: Ten sessions of TBS was feasible, well tolerated, and appeared to have clinical effects for the treatment of depressed youth. Future sham-controlled randomized trials are warranted to validate these findings in a larger cohort of youth depression.

AB - Background: Conventional treatments for youth depression, such as antidepressants, have modest efficacy, side effects, and ongoing controversies regarding safety. Repetitive transcranial magnetic stimulation (rTMS), specifically theta burst stimulation (TBS), applied to the dorsolateral prefrontal cortex (DLPFC) has demonstrated efficacy for the treatment of depression in adults. However, the feasibility and clinical response to TBS for youth depression has yet to be explored. Methods: Twenty participants between the ages of 16 to 24 years old with MDD were recruited. The intervention consisted of 10 treatment sessions over the course of two weeks, in which participants received intermittent TBS and continuous TBS stimulation to the left and right DLPFC, respectively. Change in the Hamilton Rating Scale for Depression (HRSD-17) score was the primary outcome. Clinical assessments occurred at baseline, after the fifth treatment session, and within a week after treatment completion. Results: Of the twenty participants, eighteen received all TBS sessions, and seventeen completed all clinical assessments. There was a significant reduction in depressive symptoms following treatment completion (p < 0.001). Four of the twenty patients had more than 50% reduction in their depressive symptoms, two of whom achieved remission. All participants received and tolerated at least six daily TBS treatments with no major adverse events. Limitations: Study was an uncontrolled, open-label design. Conclusion: Ten sessions of TBS was feasible, well tolerated, and appeared to have clinical effects for the treatment of depressed youth. Future sham-controlled randomized trials are warranted to validate these findings in a larger cohort of youth depression.

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