Typical Response & Remission Rates of rTMS in Treatment Resistant Cases – Dr. Martijn Arns

Posted on: February 9, 2019
Last Updated: November 14, 2019

Dr. Sanil Rege, Consultant Psychiatrist and Founder of Psych Scene and Psych Scene Hub speaks to Dr. Martijn Arns, Chief Scientific Adviser, neuroCare Group; Founding Director & Senior Researcher at Research Institute Brainclinics.

Speaker Quote : 

Response rates (with rTMS) are roughly 40-60% and remission rates are roughly around 35-40%. If you match that to the different stages in the STAR*D trial, that would be equivalent to being superior after one medication failure.

We found in a total sample of 200 patients, that the remission rate is about 55% and the response rate is about 2/3 rds (66%) (in combined TMS and psychotherapy). 

When you are putting you patient in a chair and you apply TMS, talk to the patient and apply psychotherapy. It might do your patient a favour and enhance clinical response.

Take-home Messages :

  1. Research has shown that depression is linked to disrupted communication in a specific network of brain structures including the frontal cortex (dorsolateral prefrontal cortex (DLPFC)) and the deeper anterior cingulate (ACC).
  2. Response and remission rates for rTMS with personalized psychotherapy as combined treatment in treatment-resistant depression are higher than for rTMS as a monotherapy.
  3. rTMS to the DLPFC and endogenous activation of subgenual anterior cingulate through psychotherapy could act as a double booster which may explain the higher efficacy of combined rTMS and psychotherapy.

Combining rTMS and PT resulted in a 66% response and a 56% remission rate at the end of treatment with 60% sustained remission at follow-up. No differences were found between the 10 Hz and 1 Hz TMS regarding clinical outcome. [1]

Learn more

  1. New Developments in Neuromodulation & Stimulation in Psychiatry – Dr. Martjin Arns
  2. Neurofeedback and The Role of Sleep in Psychiatric Disorders – Dr. Martjin Arns
  3. Number of Sessions & Pulses Required for Optimal Results of rTMS – Dr. Martjin Arns
  4. The Potential Side Effects of rTMS – Dr.Martjin Arns
  5. Localising The Exact Point of Maximum Stimulation For rTMS – Dr. Martjin Arns
  6. The Principle Behind Choosing The Dorsolateral Prefrontal Cortex for rTMS – Dr. Martjin Arns
  7. Key Differences Between High Frequency & Low Frequency rTMS Protocols – Dr. Martjin Arns
  8. Key Differences Between rTMS and Electroconvulsive Therapy (ECT) – Dr. Martijn Arns
  9. Clinical Indications for Repetitive Transcranial Magnetic Stimulation (rTMS) – Dr. Martijn Arns
  10. Repetitive Transcranial Magnetic Stimulation (rTMS) in Depression – Conversations with Dr. Martijn Arns, Neuromodulation Expert
  11. What are the Reasons for the Rise in Interest in Neuromodulation? – Conversations with Dr. Martijn Arns, Neuromodulation Expert
  12. How Did You Get Interested in the Field of Neuromodulation? – Conversations with Dr. Martijn Arns, Neuromodulation Expert

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