Abstract
Objective: To provide expert recommendations for the safe and effective application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder (MDD). Participants: Participants included a group of 17 expert clinicians and researchers with expertise in the clinical application of rTMS, representing both the National Network of Depression Centers (NNDC) rTMS Task Group and the American Psychiatric Association Council on Research (APA CoR) Task Force on Novel Biomarkers and Treatments. Evidence: The consensus statement is based on a review of extensive literature from 2 databases (OvidSP MEDLINE and PsycINFO) searched from 1990 through 2016. The search terms included variants of major depressive disorder and transcranial magnetic stimulation. The results were limited to articles written in English that focused on adult populations. Of the approximately 1,500 retrieved studies, a total of 118 publications were included in the consensus statement and were supplemented with expert opinion to achieve consensus recommendations on key issues surrounding the administration of rTMS for MDD in clinical practice settings. Consensus Process: In cases in which the research evidence was equivocal or unclear, a consensus decision on how rTMS should be administered was reached by the authors of this article and is denoted in the article as "expert opinion." Conclusions: Multiple randomized controlled trials and published literature have supported the safety and efficacy of rTMS antidepressant therapy. These consensus recommendations, developed by the NNDC rTMS Task Group and APA CoR Task Force on Novel Biomarkers and Treatments, provide comprehensive information for the safe and effective clinical application of rTMS in the treatment of MDD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 35-48 |
| Number of pages | 14 |
| Journal | Journal of Clinical Psychiatry |
| Volume | 79 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2018 |
ASJC Scopus subject areas
- Psychiatry and Mental health
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In: Journal of Clinical Psychiatry, Vol. 79, No. 1, 01.01.2018, p. 35-48.
Research output: Contribution to journal › Review article › peer-review
}
TY - JOUR
T1 - Consensus recommendations for the clinical application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression
AU - McClintock, Shawn M.
AU - Reti, Irving M.
AU - Carpenter, Linda L.
AU - McDonald, William M.
AU - Dubin, Marc
AU - Taylor, Stephan F.
AU - Cook, Ian A.
AU - O'Reardon, John
AU - Husain, Mustafa M.
AU - Wall, Christopher
AU - Krystal, Andrew D.
AU - Sampson, Shirlene M.
AU - Morales, Oscar
AU - Nelson, Brent G.
AU - Latoussakis, Vassilios
AU - George, Mark S.
AU - Lisanby, Sarah H.
N1 - Funding Information: Submitted: April 29, 2016; accepted October 20, 2016. Online first: May 23, 2017. Potential conflicts of interest: Dr McClintock reports research support from the National Institutes of Health/National Institute of Mental Health; has received honorarium from TMS Health Solutions/TMS Health Education; serves on the Data and Safety Monitoring Board (DSMB) for a clinical trial of repetitive transcranial magnetic stimulation (rTMS) sponsored by the Department of Veteran Affairs Cooperative Studies Program; and is an editorial board member of the Journal of ECT. Dr Reti reports current or prior research support from the National Institutes of Health, the US Department Foundation, the Simons Foundation Autism support from the Brain and Behavior Foundation, treatment of major depressive disorder: a Research Initiative, The Dana Foundation, The Neuronetics, and Brainsway and is an inventor on comprehensive summary of safety experience Johns Hopkins University School of Public Health, a McLean Hospital−owned patent on intracranial from acute exposure, extended exposure, and Neuronetics, and Brainsway and is also under seizure therapy (ICEST). Dr Nelson reports research during reintroduction treatment. J Clin contract with John Wiley and Sons for editing support from the Brain and Behavior Foundation Psychiatry. 2008;69(2):222–232.PubMed doi:10.4088/JCP.v69n0208 the volume Brain Stimulation: Methodologies and and is co-owner of AgileMedicine. Dr Latoussakis Wassermann EM, Zimmermann T. Transcranial Interventions. Dr Carpenter reports consulting reports no financial relationships with commercial magnetic brain stimulation: therapeutic income from Magstim and research support from interests. Dr George reports research support from promises and scientific gaps. Pharmacol Ther. the National Institutes of Health and through the National Institutes of Health, the Department 2012;133(1):98–107.PubMed doi:10.1016/j.pharmthera.2011.09.003 clinical trial contracts between Butler Hospital of Defense, and the Veterans Administration Salomons TV, Dunlop K, Kennedy SH, et al. and Neuronetics, NeoSync, and Cervel Neurotech and has received clinical trial contracts through Resting-state cortico-thalamic-striatal and is a member of both the National Network of the Medical University of South Carolina with connectivity predicts response to dorsomedial Depression Centers (NNDC) rTMS Task Force and Brainsway, Cervel Neurotech, Neuronetics, and prefrontal rTMS in major depressive disorder. the American Psychiatric Association (APA) Council NeoSync. His research division has received Neuropsychopharmacology. 2014;39(2): on Research and Quality. Dr McDonald reports material transfer from Brainsway, Neuronetics, 488–498.PubMed doi:10.1038/npp.2013.222 research support from the National Institute of and MECTA. He serves on the DSMB for a clinical Liston C, Chen AC, Zebley BD, et al. Default Mental Health, National Institute of Neurological trial sponsored by MicroTransponder, is an unpaid mode network mechanisms of transcranial Disorders and Stroke, Health Resources and consultant to Nervive, has received consulting magnetic stimulation in depression. Biol Services Administration, Stanley Foundation, income from Tal Medical, and receives an editor’s Psychiatry. 2014;76(7):517–526.PubMed doi:10.1016/j.biopsych.2014.01.023 Soterix, Neuronetics, and Cervel Neurotech; is a stipend from Elsevier, which publishes Brain Barker AT, Jalinous R, Freeston IL. Non-invasive consultant on the Neurological Devices Panel of Stimulation. Dr Lisanby reports research support magnetic stimulation of human motor cortex. the Medical Devices Advisory Committee, Center from Brainsway, NexStim, NeoSync, Stanley Medical Lancet. 1985;1(8437):1106–1107.PubMed doi:10.1016/S0140-6736(85)92413-4 for Devices and Radiological Health, Food and Research Foundation, Brain Behavior Foundation, Barker AT, Freeston IL, Jabinous R, et al. Clinical Drug Administration; is a member of the APA the National Institutes of Mental Health, and evaluation of conduction time measurements Council on Research and Quality representing National Institute of Neurological Disorders and in central motor pathways using magnetic electroconvulsive and neuromodulation therapies; Stroke. Her laboratory has received equipment stimulation of human brain. Lancet. has a contract with Oxford University Press to support from Soterix, MagVentures, and Magstim. 1986;1(8493):1325–1326.PubMed doi:10.1016/S0140-6736(86)91243-2 co-edit a book, the Clinical Guide to Transcranial She has patent applications on brain stimulation George MS, Wassermann EM, Williams WA, et al. Magnetic Stimulation in the Treatment of Depression; technology assigned to Columbia University and Daily repetitive transcranial magnetic and serves on editorial boards for American Journal Duke University and receives no royalties. She has stimulation (rTMS) improves mood in of Geriatric Psychiatry and Journal for ECT and is equipment loans from Magstim and MagVenture depression. Neuroreport. 1995;6(14): section editor for Current Psychiatry Reports. Dr and is an editorial board member of the Journal of 1853–1856.PubMed doi:10.1097/00001756-199510020-00008 Dubin reports grant support from Tal Medical ECT, Brain Imaging and Behavior, and International George MS, Lisanby SH, Avery D, et al. Daily left and a materials transfer from Neuronetics. Dr Journal of Geriatric Psychiatry. prefrontal transcranial magnetic stimulation Taylor reports research support from the National therapy for major depressive disorder: a sham-Institute of Mental Health, St Jude Medical, controlled randomized trial. Arch Gen Psychiatry. Neuronetics, and Vanguard Research Group. 2010;67(5):507–516.PubMed doi:10.1001/archgenpsychiatry.2010.46 Dr Cook reports research support from Aspect Holtzheimer PE III, McDonald WM. A Clinical Medical Systems/Covidien, National Institutes of Guide to Transcranial Magnetic Stimulation. New Health, Neuronetics, and Shire; has been on the York, NY: Oxford University Press; 2014. doi:10.1093/med/9780199926480.001.0001 speakers’ bureau for Neuronetics and the Medical Levinson AJ, Fitzgerald PB, Favalli G, et al. Education Speakers Network; and has been an Evidence of cortical inhibitory deficits in major advisor/consultant/reviewer for Allergan, Covidien, depressive disorder. Biol Psychiatry. Pfizer, Neuronetics, NeuroSigma, National 2010;67(5):458–464.PubMed doi:10.1016/j.biopsych.2009.09.025 Institutes of Health (Interventions Committee for Hutton TM. The clinical application of Adult Disorders [ITVA]), and US Departments of transcranial magnetic stimulation. Psychiatr Defense and Justice and Veterans Affairs (DSMB). Ann. 2014;44(6):305–309. doi:10.3928/00485713-20140609-09 He is a member of the editorial board of the World Cook IA, Espinoza R, Leuchter AF. Journal of Biological Psychiatry and editor of the Neuromodulation for depression: invasive and Patient Management section of the American noninvasive (deep brain stimulation, Psychiatric Association’s FOCUS journal. Dr Cook’s transcranial magnetic stimulation, trigeminal biomedical intellectual property is assigned to nerve stimulation). Neurosurg Clin N Am. the Regents of the University of California, and 2014;25(1):103–116.PubMed doi:10.1016/j.nec.2013.10.002 he owns stock options in NeuroSigma, where he Nguyen K-H, Gordon LG. Cost-effectiveness of serves as Chief Medical Officer. Dr O’Reardon repetitive transcranial magnetic stimulation reports research support from the Stanley Medical versus antidepressant therapy for treatment-Research Foundation and NeoSync. Dr Husain resistant depression. Value Health. reports research support from the National 2015;18(5):597–604.PubMed doi:10.1016/j.jval.2015.04.004 Institute of Mental Health, National Institute of Simpson KN, Welch MJ, Kozel FA, et al. Cost-Neurological Disorders and Stroke, Stanley Medical effectiveness of transcranial magnetic Research Foundation, Neuronetics, Magstim stimulation in the treatment of major (equipment only), Brainsway, and NeoSync and depression: a health economics analysis. Adv consulting income from Cerebain Biotech. He is a Ther. 2009;26(3):346–368.PubMed doi:10.1007/s12325-009-0013-x consultant to the Neurological Devices Panel of the Sackeim HA. Acute continuation and Medical Devices Advisory Committee, Center for maintenance treatment of major depressive Devices and Radiological Health, Food and Drug episodes with transcranial magnetic Administration and an editorial board member stimulation. Brain Stimulat. 2016;9(3):313–319.PubMed doi:10.1016/j.brs.2016.03.006 of the Journal of ECT. Dr Wall reports no financial Connolly KR, Helmer A, Cristancho MA, et al. relationships with commercial interests. Dr Krystal Effectiveness of transcranial magnetic reports research support from the National stimulation in clinical practice post-FDA Institutes of Health, Teva, Sunovion, NeoSync, approval in the United States: results observed Brainsway, Janssen, ANS St Jude, Novartis, Azevan, with the first 100 consecutive cases of Eisai; is a consultant to Abbott, AstraZeneca, depression at an academic medical center. J Clin Attentiv, Teva, Eisai, Eli Lilly, Jazz, Janssen, Merck, Psychiatry. 2012;73(4):e567–e573.PubMed doi:10.4088/JCP.11m07413 Neurocrine, Novartis, Otsuka, Pfizer, Lundbeck, Lefaucheur JP, André-Obadia N, Antal A, et al. Roche, Sunovion, Paladin, Pernix, and Transcept; is Evidence-based guidelines on the therapeutic an inventor on a Duke University−owned patent use of repetitive transcranial magnetic licensed to MECTA, though he derives no income stimulation (rTMS). Clin Neurophysiol. from this; and is an editorial board member of 2014;125(11):2150–2206.PubMed doi:10.1016/j.clinph.2014.05.021 SLEEP and deputy editor of Journal of ECT, Biological Schlaepfer TE, George MS, Mayberg H; WFSBP Psychiatry, Depression and Anxiety, Journal of Task Force on Brain Stimulation. WFSBP Affective Disorders, Biological Psychiatry: Cognitive guidelines on brain stimulation treatments in Neuroscience and Neuroimaging, and Mind and psychiatry. World J Biol Psychiatry. Brain. Dr Sampson reports equipment support 2010;11(1):2–18.PubMed doi:10.3109/15622970903170835 Publisher Copyright: © Copyright 2017 Physicians Postgraduate Press, Inc.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: To provide expert recommendations for the safe and effective application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder (MDD). Participants: Participants included a group of 17 expert clinicians and researchers with expertise in the clinical application of rTMS, representing both the National Network of Depression Centers (NNDC) rTMS Task Group and the American Psychiatric Association Council on Research (APA CoR) Task Force on Novel Biomarkers and Treatments. Evidence: The consensus statement is based on a review of extensive literature from 2 databases (OvidSP MEDLINE and PsycINFO) searched from 1990 through 2016. The search terms included variants of major depressive disorder and transcranial magnetic stimulation. The results were limited to articles written in English that focused on adult populations. Of the approximately 1,500 retrieved studies, a total of 118 publications were included in the consensus statement and were supplemented with expert opinion to achieve consensus recommendations on key issues surrounding the administration of rTMS for MDD in clinical practice settings. Consensus Process: In cases in which the research evidence was equivocal or unclear, a consensus decision on how rTMS should be administered was reached by the authors of this article and is denoted in the article as "expert opinion." Conclusions: Multiple randomized controlled trials and published literature have supported the safety and efficacy of rTMS antidepressant therapy. These consensus recommendations, developed by the NNDC rTMS Task Group and APA CoR Task Force on Novel Biomarkers and Treatments, provide comprehensive information for the safe and effective clinical application of rTMS in the treatment of MDD.
AB - Objective: To provide expert recommendations for the safe and effective application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder (MDD). Participants: Participants included a group of 17 expert clinicians and researchers with expertise in the clinical application of rTMS, representing both the National Network of Depression Centers (NNDC) rTMS Task Group and the American Psychiatric Association Council on Research (APA CoR) Task Force on Novel Biomarkers and Treatments. Evidence: The consensus statement is based on a review of extensive literature from 2 databases (OvidSP MEDLINE and PsycINFO) searched from 1990 through 2016. The search terms included variants of major depressive disorder and transcranial magnetic stimulation. The results were limited to articles written in English that focused on adult populations. Of the approximately 1,500 retrieved studies, a total of 118 publications were included in the consensus statement and were supplemented with expert opinion to achieve consensus recommendations on key issues surrounding the administration of rTMS for MDD in clinical practice settings. Consensus Process: In cases in which the research evidence was equivocal or unclear, a consensus decision on how rTMS should be administered was reached by the authors of this article and is denoted in the article as "expert opinion." Conclusions: Multiple randomized controlled trials and published literature have supported the safety and efficacy of rTMS antidepressant therapy. These consensus recommendations, developed by the NNDC rTMS Task Group and APA CoR Task Force on Novel Biomarkers and Treatments, provide comprehensive information for the safe and effective clinical application of rTMS in the treatment of MDD.
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JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
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