[HTML][HTML] Clinical outcomes in a large registry of patients with major depressive disorder treated with Transcranial Magnetic Stimulation
Journal of Affective Disorders, 2020•Elsevier
Background Randomized clinical trials have demonstrated that Transcranial Magnetic
Stimulation (TMS) is an effective treatment for episodes of major depressive disorder (MDD).
However, characterization of outcomes in routine clinical practice is needed, as well as
identification of patient-and treatment-related outcome predictors. This study documented
patient-rated (PHQ-9) and clinician-rated (CGI-S) clinical outcomes in the NeuroStar®
Advanced Therapy System Clinical Outcomes Registry. Methods Registry data were …
Stimulation (TMS) is an effective treatment for episodes of major depressive disorder (MDD).
However, characterization of outcomes in routine clinical practice is needed, as well as
identification of patient-and treatment-related outcome predictors. This study documented
patient-rated (PHQ-9) and clinician-rated (CGI-S) clinical outcomes in the NeuroStar®
Advanced Therapy System Clinical Outcomes Registry. Methods Registry data were …
Background
Randomized clinical trials have demonstrated that Transcranial Magnetic Stimulation (TMS) is an effective treatment for episodes of major depressive disorder (MDD). However, characterization of outcomes in routine clinical practice is needed, as well as identification of patient- and treatment-related outcome predictors. This study documented patient-rated (PHQ-9) and clinician-rated (CGI-S) clinical outcomes in the NeuroStar® Advanced Therapy System Clinical Outcomes Registry.
Methods
Registry data were collected at 103 practice sites. Of 7759 participants, 5010 patients 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 = 3,814) were responders or had received ≥ 20 sessions and had an end of acute treatment PHQ-9 assessment. CGI-S ratings were obtained in smaller samples.
Results
In the total ITT and Completer samples, response (58–83%) and remission (28–62%) rates were notably high across self-report and clinician-administered assessments. Female patients and those treated with a larger number of pulses per session had superior clinical outcomes.
Limitations
Site participation in the registry was voluntary and treatment was open label.
Conclusions
The extent of clinical benefit reported by patients and clinicians following TMS in routine practice compares favorably with alternative interventions for treatment-resistant depression. Strong efficacy and the low side effect and medical risk profile suggest that TMS be evaluated as a first-line treatment for MDD. The findings derive from the largest registry of clinical outcomes in MDD for any treatment.
Elsevier
