Breaking the Barriers to Brain Stimulation: Accelerated TMS Offers Recent Hope for Depression
For individuals battling treatment-resistant depression, transcranial magnetic stimulation (TMS) has emerged as a vital option. However, the traditional treatment schedule – daily clinic visits spanning six to eight weeks – presents a significant hurdle for many. Now, groundbreaking research suggests a dramatically accelerated approach may offer comparable results in a fraction of the time.
The Promise of “5×5” TMS
A recent study from UCLA Health investigated the efficacy of an accelerated TMS protocol, dubbed “five-by-five” or “5×5.” This involves delivering five TMS sessions per day for five consecutive days. The research, published in the Journal of Affective Disorders, compared 175 patients with treatment-resistant depression, finding that both the conventional and accelerated approaches led to meaningful reductions in depressive symptoms, with no significant difference in overall outcomes.
“For patients with treatment-resistant depression, getting to the clinic every weekday for at least six weeks can be a real obstacle,” explains Michael Apostol, a Ph.D. Student at the UCLA Semel Institute for Neuroscience and Human Behavior. “What this study suggests is that we may be able to offer those same patients a path to meaningful relief in less than one week by condensing 25 TMS treatments over just five days.”
Delayed Benefits: A Key Finding
Interestingly, the study revealed a significant finding regarding a subgroup of patients in the accelerated group. Those who initially showed limited improvement immediately after completing the five-day course experienced substantial symptom reduction – an average 36% decrease in depression scores – when followed up two to four weeks later.
This suggests that evaluating the effectiveness of accelerated TMS requires a longer-term perspective. Patients who don’t feel better immediately shouldn’t lose hope, as benefits may emerge in the weeks following treatment. As Dr. Andrew Leuchter, director of the TMS Service at UCLA, notes, “Some patients need to wait a few days or weeks to see benefit, and we encourage them not to deliver up too quickly if they don’t feel better right away.” He also indicated that adding one or two days of treatment after a two-week period may further enhance the benefits of the 5×5 approach.
TMS: A Growing Field Beyond Depression
While the conventional six-week TMS treatment remains effective and continues to outperform the accelerated approach on some longer-term measures, the potential of accelerated protocols is undeniable. Researchers are actively exploring new applications for TMS beyond depression, including obsessive-compulsive disorder and chronic pain. This positions TMS as a central component of the next generation of brain-based therapies for mental health.
TMS is an established treatment option for treatment-resistant depression, with studies showing significant symptom reduction in 60-70% of patients, and remission achieved by 25-35%. It is generally covered by most insurance plans.
What is Transcranial Magnetic Stimulation?
TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It’s approved by the FDA since 2008 for the treatment of depression and doesn’t require surgery or sedation. During a session, an electromagnetic coil is placed against the scalp, delivering pulses to the dorsolateral prefrontal cortex, a brain region involved in mood control.
Frequently Asked Questions
What is treatment-resistant depression?
Treatment-resistant depression refers to major depressive disorder (MDD) that hasn’t responded adequately to multiple trials of antidepressant medication.
Is TMS painful?
TMS is generally well-tolerated. Patients may experience mild tapping or clicking sensations during the session, and earplugs are provided to minimize noise.
Are there any side effects of TMS?
Common side effects are typically mild and temporary, such as headache or scalp discomfort.
How does TMS differ from ECT?
Unlike electroconvulsive therapy (ECT), TMS is noninvasive and doesn’t require anesthesia or sedation. Patients remain awake and alert during TMS sessions.
What should I remove before a TMS session?
Patients must remove any magnetic-sensitive objects, such as jewelry and hearing aids, prior to treatment.
Did you know? Accelerated TMS protocols like “5×5” are being investigated to make brain stimulation therapies more accessible to patients facing logistical challenges.
Pro Tip: If you’re considering TMS, discuss the potential benefits and risks with a qualified healthcare professional to determine if it’s the right treatment option for you.
Further Reading: Learn more about TMS and depression at Mayo Clinic and Verywell Health.
Have you or someone you know experienced TMS therapy? Share your thoughts and questions in the comments below!
