Music and rTMS; Novel combination approach for the treatment of depression

Abstract

Abstract: Background: Standard treatments are often ineffective in Major Depressive Disorder (MDD). Repetitive Transcranial Magnetic Stimulation (rTMS) is effective in treatment resistant MDD. Music therapy is an established health profession with proven benefits in depression and anxiety. Combining treatments with rTMS often improves outcomes. We introduce proof of concept for novel combination approach, music with rTMS. Methods/Design: Nine adult patients with treatment resistant MDD were treated. TMS was delivered using H1-coil to left dorsolateral prefrontal cortex using standard high frequency parameters. Patients listened to music simultaneously with stimulation every session for 20 minutes. The type of music played was based on the patient’s preference. They were asked to choose something that induces positive emotions in them, possibly chills or Goosebumps (i.e intense pleasure). Response was measured with Hamilton Depression Rating Scale (HAM-D). Results: Response and remission rates were 89% and 56% respectively. Mean change in total HAM-D score was –15.3 (SD=3.6). There were no treatment emergent side effects. Conclusion: We demonstrate the feasibility of combining music with rTMS in this open label proof of concept series. This method is easy to set up and deliver. We encourage more research into this area for finding proof of efficacy. Disclosures – None