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

Posted on February 9, 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.

Author 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 personalised psychotherapy as a 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]

Reference:

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