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 Quotes 

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 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]

Quiz

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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