Accelerated intermittent theta burst transcranial magnetic stimulation is a safe and efficacious treatment for adolescents with depressive symptoms

Abstract

Abstract Background: Intermittent theta burst stimulation (iTBS) has been shown to be a safe and effective therapy for depression in adult populations and more recently, newer protocols of accelerated transcranial magnetic stimulation (TMS) have become popularized due to the fast-acting effects. Previous literature has shown that iTBS in adolescents is safe and that TMS may be more effective in younger individuals, but it has yet to be explored in great detail with accelerated protocols. Methods: This case series describes three patients seen in the context of an outpatient clinic setting at Acacia Mental Health. The patients were treated for depressive symptoms which were confirmed by a staff psychiatrist. Self-reported mood surveys as assessed by the patient health questionnaire-9 (PHQ-9), were administered pre-treatment and post-treatment. The accelerated TMS treatment protocol administered to these patients varied in the brain region(s) targeted, TMS machine output intensity, protocol laterality, number of sessions per day, and total number of sessions. The TMS treatments were delivered via a MagVenture MagPro R30 system (MagVenture A/S, Denmark) equipped with a MagVenture Cool-B65 A/P coil. Results: All three cases were prescribed distinct accelerated protocols; two achieved self-reported remission and one achieved response as measured by the PHQ-9. All patients tolerated accelerated iTBS sessions without significant adverse events, demonstrating that this is a safe and effective treatment for adolescents with MDD. Conclusion: In these adolescent patients, accelerated TMS protocols were tolerated and showed meaningful clinical effects. These cases support rationale for future clinical applications of accelerated TMS in adolescent populations. Future studies should examine larger cohorts to gain a deeper understanding of accelerated TMS safety and efficacy in adolescents. Research Category and Technology and Methods Clinical Research: 10. Transcranial Magnetic Stimulation (TMS) Keywords: Transcranial Magnetic Stimulation, Theta Burst, Adolescence, Depression