Abstract
Objective: Present the outcomes data from the leading United Kingdom (UK) National Health Service (NHS) clinical rTMS service provider.
Background: Northamptonshire Healthcare NHS Foundation Trust’s (NHFT) Centre for Neuromodulation was the first and is the largest NHS provider of clinical rTMS to patients in the UK. It provides FDA protocol rTMS for depression. The centre has been innovative in the UK by treating anxiety using right DLPFC inhibitory rTMS prior to the delivery of FDA left dorsolateral prefrontal cortex rTMS in treatment resistant depression patients with anxiety.
Design/Methods: A retrospective investigation of routinely collected data between 2016 and 2018 was undertaken. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Generalised Anxiety Disorder (GAD-7), and Physical Health Questionnaire (PHQ-9). The outcome data of 61 patients with TRD was analysed. The sample included patients with co-morbid psychiatric diagnosis.
Results: Response and remission rates respectively were 17.1% and 27.3% for the GAD-7; 20.7% and 12.5% for the HAM-D; 19% and 24% for the PHQ; and 20% and 23.5% for the CGI. Post-treatment scores significantly improved for the GAD-7, HAM-D and CGI scales with medium to large effect sizes (.61, .62 and .86 respectively).
Conclusions: Results indicate the potential value of rTMS in treating anxiety in those who are referred for rTMS for treatment resistant depression. Well designed and adequately powered randomised controlled trials are required to determine clinical recommendations.
Background: Northamptonshire Healthcare NHS Foundation Trust’s (NHFT) Centre for Neuromodulation was the first and is the largest NHS provider of clinical rTMS to patients in the UK. It provides FDA protocol rTMS for depression. The centre has been innovative in the UK by treating anxiety using right DLPFC inhibitory rTMS prior to the delivery of FDA left dorsolateral prefrontal cortex rTMS in treatment resistant depression patients with anxiety.
Design/Methods: A retrospective investigation of routinely collected data between 2016 and 2018 was undertaken. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Generalised Anxiety Disorder (GAD-7), and Physical Health Questionnaire (PHQ-9). The outcome data of 61 patients with TRD was analysed. The sample included patients with co-morbid psychiatric diagnosis.
Results: Response and remission rates respectively were 17.1% and 27.3% for the GAD-7; 20.7% and 12.5% for the HAM-D; 19% and 24% for the PHQ; and 20% and 23.5% for the CGI. Post-treatment scores significantly improved for the GAD-7, HAM-D and CGI scales with medium to large effect sizes (.61, .62 and .86 respectively).
Conclusions: Results indicate the potential value of rTMS in treating anxiety in those who are referred for rTMS for treatment resistant depression. Well designed and adequately powered randomised controlled trials are required to determine clinical recommendations.
| Original language | English |
|---|---|
| Article number | 123 |
| Pages (from-to) | 398 |
| Number of pages | 1 |
| Journal | Brain Stimulation |
| Volume | 12 |
| Issue number | 2 |
| DOIs | |
| Publication status | E-pub ahead of print - 22 Jan 2019 |
Bibliographical note
Copyright © 2018 Published by Elsevier Inc.Keywords
- rTMS
- depression
- anxiety