Comparison of the Efficacy of Accelerated Intermittent Theta Burst Stimulation and Accelerated Continuous Theta Burst Stimulation in Patients With Treatment-Resistant Depression
Ataturk University
60 participants
Nov 15, 2025
INTERVENTIONAL
Conditions
Summary
In recent years, research on the effectiveness of transcranial magnetic stimulation (TMS) in patients with treatment-resistant depression (RTD) has been steadily increasing. The aim of this study was to examine the effectiveness of accelerated unilateral application of two different forms of theta burst stimulation (TBU), a variation of repetitive TMU (rTMS)-intermittent TBU (iTBU) and continuous TBU (cTBU)-in TDD patients. The study aimed to compare the advantages of iTBU and cTBU protocols on depression, suicidal thoughts, anxiety levels, sleep disturbances, cognitive performance, and overall functioning following a two-week intensive treatment period and a 12-week follow-up period.
Eligibility
Inclusion Criteria10
- to 65 years old
- Patients diagnosed with Major Depressive Disorder according to DSM 5 and the severity of their illness
- Scoring 7 points or more on the Maudsley staging method
- Having depression unresponsive to 2 different antidepressants
- No clinical mental retardation
- Agree to participate in the study
- Hamilton Depression Rating Scale-17 \[HDRS\] score of 20 or higher
- Montgomery Asberg Depression Rating Scale \[MADRS\] score of 20 or above
- Being right hand dominant
- Having used the same antidepressant at the same dose for the last 4 weeks
Exclusion Criteria7
- Diagnosed with a neurological or metabolic disease that affects cognitive functions (Systemic diseases such as diabetes mellitus, cardiovascular disease, cerebrovascular disease, chronic renal failure, Parkinson's disease, multiple sclerosis, polyneuropathy, inflammatory rheumatologic disease and malignancies)
- Having a foreign body such as a pacemaker, intracranial implant that can magnetically interact
- Hearing and visual impairments that prevent communication
- Unstable or acute medical conditions
- Pregnancy or breastfeeding
- Having a primary psychiatric disorder other than major depressive disorder
- Being diagnosed with severe MDD with psychotic features
Interventions
A total of 50 sessions will be administered to at least 30 patients, five sessions per day, five days a week for two weeks. There will be at least a 30-minute rest period between each session. One session for Group A involves a 5 Hz frequency intermittent theta burst stimulation (iTBS) protocol applied to the left DLPFC at 90-110% motor threshold.
The other patient group (Group B), consisting of at least 30 individuals, will receive 5 sessions per day, 5 days a week, for 2 weeks, for a total of 50 sessions. There will be at least a 30-minute rest period between each session. Group B will receive a 5 Hz, continuous theta burst stimulation (cTBS) protocol to the right DLPFC at 80% motor threshold.
Locations(1)
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NCT07264452