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One hundred courses of cluster maintenance transcranial magnetic stimulation (CM TMS) – A clinical audit study
Pridmore, S and O'Reilly, J and Naguy, A and Morey, R and Turnier-Shea, Y and Rybak, M, One hundred courses of cluster maintenance transcranial magnetic stimulation (CM TMS) - A clinical audit study, Psychopharmacology Bulletin, 52, (4) pp. 61-68. ISSN 2472-2448 (2022) [Refereed Article]
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Objective: Major depressive disorder (MDD) which comes to transcranial magnetic stimulation (TMS) is prone to relapse. Cluster maintenance (CM) TMS is courses of 5 treatments delivered over 2.5-5 days, separated by monthly or greater non-treatment periods. Our aim was to characterize the outcomes of 100 courses of CM TMS.
Method: This was a Quality Assurance/Clinical Audit study. We studied consecutive CM TMS courses provided to private hospital inpatients. Mood was rated (on admission and discharge) using the six-item Hamilton depression rating (HAMD6) and the Clinical Global Impression - Severity (CGI-S) scales. We also applied recent STAR*D criteria which are designed to measure the 'clinical change' expected to impact patient function .
Results: For the total sample, using the HAMD6, 83% of courses featured relapse or partial relapse on admission, and 81% featured remission on discharge. Of 46 courses featuring HAMD6 relapse on admission, 74% featured remission on discharge. For the 100 courses the HAMD6 discharge scores were significantly lower than the admission scores (p = 2.0 × 10-24), as were the CGI-S scores (p = 1.8 × 10-25). Using STAR*D criteria for people in relapse or partial relapse on admission, CM TMS provided least a 'clinically meaningful' outcome in 82% of the cases.
Conclusion: For courses featuring relapse or partial relapse on admission, CM TMS converted greater than 70% to remission at discharge. It produced statistically significant reductions in HAMD6 and CGI-S scores, and using STAR*D criteria, at least 'clinically meaningful' change was extensively demonstrated. This evidence indicates CM TMS should be readily available to people living with relapsing MDD.
|Item Type:||Refereed Article|
|Keywords:||maintenance treatment, major depressive disorder, relapse, remission, transcranial magnetic stimulation|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Psychiatry (incl. psychotherapy)|
|Objective Group:||Public health (excl. specific population health)|
|Objective Field:||Mental health|
|UTAS Author:||Pridmore, S (Professor Saxby Pridmore)|
|UTAS Author:||O'Reilly, J (Mr Jeremy O'Reilly)|
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