Breaking New Ground: Accelerated iTBS Studies Offer Hope for Adolescent Depression Treatment

Breaking New Ground: Accelerated iTBS Studies Offer Hope for Adolescent Depression Treatment

OCT 10

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Accelerated TMS for Adolescents with Depression

Acacia presented data at the 5th International Brain Stimulation conference in Lisbon, Portugal on the topic of accelerated iTBS for the treatment of adolescent depression. The prevalence of adolescent depression is steadily rising but unlike adults, less than half with severe impairment receive treatment. rTMS approaches could be transformational for adolescents and previous studies have demonstrated its safety. Accelerated iTBS, which describes multiple stimulation sessions per day, may improve treatment efficacy in adults, even adults whom have had TMS previously. This approach has not been widely adopted for adolescents, however. In this case series, 3 adolescents with depressive symptoms (2 male, 1 female, 16-18 years of age) received accelerated iTBS to Beam F3 (and F4 in two cases). Following their treatment course, 1 patient had a remission of symptoms based on the PHQ-9 scale, and 2 patients had a clinical response (≥50% reduction in symptoms) (see graph). Only mild and expected adverse events were experienced and were all resolved at follow-up. Accelerated iTBS may be a safe and effective approach to achieve rapid symptom relief for adolescents with depression. 

Individualized fMRI-based Targets in Adolescents with Depression

In another recent case series presented at the 2023 Clinical TMS Society Annual Meeting, our team presented novel data demonstrating the utility of fMRI-guided accelerated iTBS for the treatment of adolescent depression. The patients (3 males, 16-17 years of age) received 50 iTBS treatment sessions over 5 days to personalized left dorsolateral prefrontal cortex (DLPFC) brain targets based on fMRI-connectivity to the subgenual cingulate cortex (panels A-D). Two patients (Case 1 and Case 2) achieved remission based on the PHQ-9 scale (see graph), while Case 3 experienced a 37% reduction in depression symptoms. This approach was safe and well-tolerated by all patients and offers a promising individualized approach to manage depression symptoms in adolescents. 

Reference: Nakano, E., Veerapal, C., DeSouza, D., Meng, N., & Carreon, D. (2023). Accelerated intermittent theta burst transcranial magnetic stimulation is a safe and efficacious treatment for adolescents with depressive symptoms. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 16(1), 401. https://doi.org/10.1016/j.brs.2023.01.813