Efficacy of Intermediate Theta Burst Versus High-Frequency Repetitive Transcranial Magnetic Stimulation in Treatment-Resistant Depressive Patients Using Electroencephalography

Mahmoud  Bagheri; Javad Hosseini  Nejad; Hassan  Tavakoli; Seyed Abbas  Tavallaie; Aliakbar  Karimi Zarchi

doi:10.18502/fbt.v12i2.18280

Mahmoud Bagheri Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Javad Hosseini Nejad Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Hassan Tavakoli Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Seyed Abbas Tavallaie Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Aliakbar Karimi Zarchi Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/fbt.v12i2.18280

Keywords: Transcranial Magnetic Stimulation; Treatment-Resistant Depression; Intermittent Theta Burst Stimulation; Electroencephalography

Abstract

Purpose: This study was conducted to evaluate the comparative effectiveness of repetitive Transcranial Magnetic Stimulation (rTMS) and intermittent Theta Burst Stimulation (iTBS), in Treatment-Resistant Depression (TRD) patients using resting-state Electroencephalography (EEG). iTBS is a novel form of magnetic stimulation with the potential to produce similar anti-depressant effects but in a much shorter time.

Materials and Methods: In two stimulation protocols, 78 patients with TRD received 20 sessions. Depression symptoms were assessed based on the changes in the Hamilton Depression Rating Scale (HAM-D) and Beck Depression Inventory (BDI-II) scores at baseline, after the last session, and at 4 weeks after treatment. Resting-state EEG was measured at baseline and after the last session. EEG power spectrum was extracted and power changes were evaluated statistically.

Results: There was no significant difference in response and remission rates between the two groups. Following 10 Hz rTMS and iTBS, the clinical indexes improved by 48.5 ± 19.8 % (p-value < 0.05) and 50.4 ± 21.7 % (p-value < 0.05), respectively. There was a significant reduction in the mean depression scores for both treatment groups (p < 0.05). Following treatment, TRD patients showed considerable enhancement in gamma power at the left DLPFC site (F3, F5, and F7 electrode) in the iTBS group and significant increases in delta power at the F3 and F7 electrode sites in the 10 Hz rTMS group.

Conclusion: iTBS provides clinical advantages, which showed that the results did not contrast altogether with results from a standard course of rTMS treatment. It might be invaluable from a clinical, benefit, and understanding perspective. Biomarkers of clinical outcomes such as resting-state brain activity measured with EEG may save individuals worthless treatment and moderately limited clinical assets.