New Insights into Transcranial Magnetic Stimulation (TMS) Treatment of Depression

Transkranijalna magnetska stimulacija (TMS) je neinvazivni postupak modulacije moždane aktivnosti. Magnetsko polje nastalo u elektromagnetskoj zavojnici inducira električnu aktivnost u korteksu mozga. TMS je učinkovit u tretmanu depresivnog poremećaja koji je vodeći svjetski uzrok invaliditeta i glavni poremećaj na ljestvici opterećenja svim bolestima. Više od 30 % bolesnika liječenih zbog depresivnog poremećaja su rezistentni na farmakološke tretmane. U radu ćemo predstaviti nove spoznaje u liječenju depresivnog poremećaja transkranijalnom magnetskom stimulacijom (TMS-om). Broj centara koji koriste TMS za liječenje depresivnog poremećaja je u porastu širom svijeta. Psihijatrijska bolnica „Sveti Ivan“ je prva bolnica u Hrvatskoj u kojoj se provodi liječenje transkranijalnom magnetskom stimulacijom (TMS-om). Od 2016. godine provodimo liječenje repetitivnom transkranijalnom magnetskom stimulaciju (rTMS-om) i dubokom transkranijalnom magnetskom stimulacijom (dTMS-om).Transcranial magnetic stimulation TMS is a non-invasive brain modulation procedure. Magnetic field pulses created in the electromagnetic coil produce electrical activity in the brain. TMS is effective treatment for depression which is the leading cause of disability worldwide and it is a major contributor to the overall global burden of disease. More than 30% of patients treated for depression are resistant to pharmacological treatments. Hereby we present the new insights into transcranial magnetic stimulation (TMS) treatment of depression. Worldwide, the number of centers using TMS to treat depression is increasing. In Psychiatric Hospital „Sveti Ivan“ patients are treated with transcranial magnetic stimulation (rTMS) from the beginning of 2016. We also provide deep transcranial magnetic stimulation (dTMS) treatment and we are the first hospital in Croatia to provide patients with Transcranial Magnetic Stimulation (TMS) to treat depression

EFFICACY AND SAFETY OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION USING AN H1-COIL OR FIGURE-8-COIL IN THE TREATMENT OF UNIPOLAR MAJOR DEPRESSIVE DISORDER: A STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique with few side effects that has been reported to be effective in the treatment of major depressive disorder (MDD). At present, no randomized controlled trials (RCT) have compared the efficacy and safety of rTMS delivered by the figure-8-coil and the H1-coil. We describe an industry-independent, randomized, controlled, single-blinded, single-center study protocol assessing the differences in efficacy and safety of rTMS for patients diagnosed with MDD with the H1-coil and figure-8-coil as an add-on to stable pharmacotherapy or pharmacotherapy alone. Stimulation protocols follow those that led to the FDA clearance of these treatments for MDD. The sample of 76 patents in each of the three groups will be enrolled and assessed with clinical and neuropsychological tests. The primary outcome is remission rate defined as Hamilton depression rating scale (HAM-D17) score ≤7 at the end of week-4. This clinical trial will address the efficacy and safety of rTMS modalities for MDD. The evaluation of biological markers will also help to elucidate the pathophysiology of MDD and the mechanisms of action of rTMS