A 6 month follow up study on response and relapse rates following an acute trial of repetitive transcranial magnetic stimulation (rTMS) in patients with major depression

Introduction: Little is known about post-acute effects of repetitive transcranial magnetic stimulation (rTMS) in patients with Major Depression. The present study focused on the 6 month-follow up of a sample of patients with Major Depression, after the completion of an acute 4 weeks rTMS trial, with the aim of evaluating response (in terms of sustained and late response) and relapse rates. Methods: Following the completion of an acute trial of rTMS (T0-T4), 31 drug-resistant depressed patients (bipolar or unipolar) entered a naturalistic follow-up period of six months, with three timepoints (T5, T6 and T7) during which they were assessed with the Hamilton Depression Rating Scale and the Young Mania Rating Scale. Results: Results showed that in the 6 months following an acute TMS trial, a higher rate of late responders was observed among previously acute TMS non-responders (63,64%, 7 out of 11) compared to the rate of relapse among those who had acutely responded to TMS (10%, 2 out of 20). In addition, an overall high rate of maintained response (90%) was observed. Conclusion: Present findings seem to support the possibility of obtaining a clinical response also after the end of an acute TMS trial in patients with Major Depression. The concomitant low rate of relapse observed at the end of follow-up along with a high rate of maintained response provide further support to the post-acute efficacy of TMS. Nonetheless, further controlled studies with larger samples and longer follow-up observation are needed to confirm reported results.