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Effects of Hesel-coil deep transcranial magnetic stimulation for depression: a systematic review
Örebro University, School of Medical Sciences. Department of Psychiatry.ORCID iD: 0000-0001-7454-3065
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Health Economist, Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
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2016 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 7, 492-497 p.Article, review/survey (Refereed) Published
Abstract [en]

Background: One third of the depressed patients are not improved by antidepressant drugs and psychological treatments, and there is a need for additional treatments. Repetitive transcranial magnetic stimulation (rTMS) is being developed towards an alternative in treatment-resistant depression. Deep transcranial stimulation (dTMS) with the Hesel-coil (H-coil) is a further development of rTMS aiming to enhance the effect by getting the magnetic pulses to penetrate deeper into the brain.

Aims: This report aims to assess the evidence-base for dTMS for depression. The report also includes an assessment of the ethical and economic aspects involved.

Methods: A systematic review of the effects of H-coil dTMS on depression was conducted and the scientific support was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation).

Results: Only one controlled study was identified. In the sham-controlled randomized study, 212 participants with major depression that had not responded to antidepressant medication were enrolled. A two-point superiority in Hamilton Depression Rating Scale was observed in the dTMS arm vs the sham-arm at 4 weeks, but the difference was not statistically significant. No serious adverse events were reported apart from rare cases of epileptic seizures.

Conclusions: The existing scientific support for H-coil dTMS therapy for depression is insufficient. The clinical implication is that the use of dTMS in depression should be restricted to the framework of clinical trials pending further studies. Fortunately, additional studies are underway and the evidence base should presumably improve over the next several years.

Place, publisher, year, edition, pages
Taylor & Francis, 2016. Vol. 70, no 7, 492-497 p.
Keyword [en]
Deep transcranial magnetic stimulation (dTMS), repetitive transcranial magnetic stimulation (rTMS), electroconvulsive therapy (ECT), major depression, systematic review
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-49948DOI: 10.3109/08039488.2016.1166263ISI: 000383037300002PubMedID: 27093104Scopus ID: 2-s2.0-84964403709OAI: oai:DiVA.org:oru-49948DiVA: diva2:923363
Note

Funding Agency:

Swedish Council on Health Technology Assessment and Assessment of Social Services (SBU)

Available from: 2016-04-26 Created: 2016-04-26 Last updated: 2016-10-18Bibliographically approved

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CiteExportLink to record
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