Predicting response to TMS; we expect it 90% of the time

TMS works most of the time our offices.  Right now, >70% get to remission, and 90% of patients get response, that means less than 10% of patients don’t respond to TMS treatments.  

WE are really excited by these numbers, but that 10% non-response is hard on patients and us.  I have always said if we could predict who would get better, that would help us get more people well and find those people that need other treatments at the beginning.  

Well, some really talented researchers have submitted some impressive findings from a Randomized Controlled Trial (RCT) to the journal Brain Stimulation and it will be published soon.  I was able to get an “in press’ copy of the article and wanted to review it for this blog.  

An RCT is the best kind of study that science has to offer.  In this RCT, patients received TMS and had a baseline functional MRI which assessed the brains activity in particular areas.  The patients were treated and monitored with the same sort of assessments we use in the office.  The researchers were able to show that there are two areas of the brain that could predict response and non-response to treatment.  

Unfortunately, baseline functional MRIs are not ready for current clinical use, but one day this could be the way we pre-test or pre-screen for TMS Responsiveness.  

 

IMAGES: Blue image shows reduced

 

Ge R, Downar J, Blumberger DM, Daskalakis ZJ, Vila-Rodriguez F.  Functional connectivity of the anterior cingulate cortex predicts treatment outcome for rTMS in treatment-resistant depression at 3-month follow-up.  Brain Stimulation, https://doi.org/10.1016/j.brs.2019.10.012