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Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice

  • Philip G. Janicak (a1), David L. Dunner (a2), Scott T. Aaronson (a3), Linda L. Carpenter (a4), Terrence A. Boyadjis (a5), David G. Brock (a6), Ian A. Cook (a7), Karl Lanocha (a8), Hugh B. Solvason (a9), Dafna Bonneh-Barkay (a6) and Mark A. Demitrack (a6)...
Abstract
Background

Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS.

Methods

Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase.

Results

Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity.

Conclusion

These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

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Copyright
The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercialShareAlike licence, http://creativecommons.org/licenses/by-nc-sa/3.0/. The written permission of Cambridge University Press must be obtained for commercial re-use
Corresponding author
*Address correspondence to: Philip G. Janicak, MD, Rush University Medical Center, Psychiatric Clinical Research Center, 2150 West Harrison Street, Room 253, Chicago, IL 60612, USA. (Email pjanicak@rush.edu)
Footnotes
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This research was supported by a grant from Neuronetics, Inc. The clinical trial was posted on http://www.clinicaltrials.gov, listing number NCT 01114477. We would like to thank the NeuroStar TMS Therapy Outcomes Study Group for their contributions to this report. We would also like to thank Seth Zuckerman, MS, for his assistance as an independent consultant with the statistical analyses in this report.

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CNS Spectrums
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