“This is an important study, because it provides the first head-to-head comparison of two different technologies that use transcranial magnetic stimulation (TMS) to treat depression,” said Markus Heilig, MD, PhD, a Professor of Psychiatry at Linköping University. “Subjects in the study demonstrated clearly higher response rates with Deep TMS, which stimulates more deeply and broadly into the brain, than with figure-8 TMS.”

Researchers at the Psychiatric Hospital “Sveti Ivan” in Croatia conducted this 228-patient randomized controlled study (NCT02917499) independent of industry support. The results appear in the July 2019 issue of the Journal of Psychiatric Research.

In this study, a total of 228 patients (the intent to treat population, or ITT) were randomized to either four weeks of dTMS (n = 72) or standard TMS (n = 75) in conjunction with standard pharmacotherapy, or to a control group treated with pharmacotherapy alone (n = 81). The primary endpoint of the study was the proportion of patients achieving remission, defined as a Hamilton Depression rating scale (HAM-D17) score of ≤ 7 after four weeks of therapy (20 treatments).

The remission rate for both the dTMS (H1-coil) group (59.7%) and the standard rTMS (figure 8-coil) group (42.7%) was significantly higher than with the control group (11.1%) in the ITT population (p < .001 and p = .001, respectively).

Other key findings from the study include:

The response rate (defined as ≥50% decrease in HAM-D17) was significantly greater with dTMS plus pharmacotherapy (66.7%) than with standard rTMS plus pharmacotherapy (44.0%) (p = .04).

There was a trend toward improved remission rate with dTMS (59.7%) compared with standard rTMS (42.7%). Although this trend did not achieve statistical significance in the ITT population, it did achieve statistical significance in the subset of ITT patients who entered the study with moderate-to-severe MDD (HAM-D17 ≥17).

The HAM-D17 was lowered by 59% in the dTMS group, 41% in the standard rTMS group (P = 0.048), and 17% in the control group (P < 0.001 vs dTMS; P = 0.003 vs standard rTMS).

No difference was seen in safety or tolerability between dTMS and standard rTMS.

“We applaud the authors for completing this landmark study confirming the value of adding Deep TMS therapy as a standard treatment option for patients suffering from moderate to severe depression,” said Yaacov Michlin, CEO of BrainsWay.

Source: Company Press Release