Overview of a large transcranial magnetic stimulation patient outcomes database

Abstract

Abstract While there is a clear evidence base from randomized clinical trials that demonstrate the efficacy of Transcranial Magnetic Stimulation (TMS) in the treatment of major depressive disorder (MDD), greater understanding of best practices in routine clinical practice is critically needed. This symposium will provide an in depth look at the first ten years of data collection of patient demographics, treatment parameters and outcomes from the NeuroStar® Advanced Therapy System Clinical Outcomes Registry. Methods: Registry data were collected at 103 practice sites. Of 7759 participants, 5010 patients were included in an intent-to-treat (ITT) sample, defined as a primary MDD diagnosis, age ≥ 18, and completion of the Patient Health Questionaire-9 (PHQ-9) before TMS and with at least one PHQ-9 assessment after baseline. Completers (N = 3,814) were responders or had received ≥ 20 sessions and had an end of acute treatment PHQ-9 assessment. CGI-S ratings were obtained in smaller samples. Results: In the total ITT and Completer samples, response (58–83%) and remission (28–62%) rates were notably high across self-report and clinician-administered assessments. Female patients and those treated with a larger number of pulses per session had superior clinical outcomes. Conclusions: The extent of clinical benefit reported by patients and clinicians following TMS in routine practice compares favorably with alternative interventions for treatment-resistant depression. Strong efficacy and the low side effect and medical risk profile suggest that TMS be evaluated as a first-line treatment for MDD. The findings demonstrate the power of creating a large registry of clinical outcomes in MDD. Keywords: TMS, treatment outcomes, registry