As you may recall, in 2016 CPCH has been treating patients with Major Depressive Disorder with TMS (transcranial magnetic stimulation). As part of the Gil Internship, we were fortunate to have Swapnil Patel, a UNC undergraduate Psychology major, to help us analyze our TMS outcomes data for 13 patients who completed the TMS protocol at CPCH. We wanted to share these exciting results:

Patient Demographics (what kind of patients completed the TMS protocol)

Measurement Tool – PHQ-9

The Patient Health Questionnaire (PHQ-9) Overview

The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression:
• The PHQ-9 incorporates DSM-IV depression diagnostic criteria with other leading major depressive symptoms into a brief self-report tool.
• The tool rates the frequency of the symptoms, which factors into the scoring severity index.
• Question 9 on the PHQ-9 screens for the presence and duration of suicide ideation.
• A follow up, non-scored question on the PHQ-9 screens and assigns weight to the degree to which depressive problems have affected the patient’s level of function.

Response = 50% reduction of symptoms on the PHQ-9
Remission = PHQ-9 score < 5

Overall Results

Figure 1a. Average patient PHQ-9 scores at baseline and following TMS treatment (n=13)

Figure 1b. Average patient response and remission rates through 20 TMS sessions (n=13)

Results from patients with severe depression

Figure 2a. Patient PHQ-9 scores after 10 and 20 TMS sessions with baseline PHQ-9 ≥ 20 (n=5)

Results from patients with moderate depression

Figure 3a. Patient PHQ-9 scores after 10 and 20 TMS sessions with baseline PHQ-9 11-19 (n=7)

Results from patients with mild depression

Figure 4a. Patient PHQ-9 scores after 10 and 20 TMS sessions with baseline PHQ-9 ≤ 10 (n=1)

So what does it all mean? Here are the take-away points:

• About 85% of our patients experienced improvement in depression using TMS.
• About 60% of our patients experienced a significant improvement in depression using TMS.
• About 30% of our patients experienced complete relief from depression using TMS.
• TMS was effective for patients experiencing mild, moderate, and severe depression symptoms.

Some additional notes on the TMS experience:

• Most common side effect was mild headache for the first week of TMS sessions.
• Results shown are after 20 sessions of TMS, patients may experience additional improvement in depression if they continue to do 30-40 sessions of TMS.
• Some patients elected to continue depression medications after TMS and others discontinued depression medications.

If you would like to know if you are a candidate for dTMS please contact our offices at 919-636-5240.

Live Mentally Healthy,
Dr. Jennie Byrne