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Deep TMS for adolescents with treatment-resistant depression: A preliminary dose-finding study exploring safety and clinical effectiveness

Key Takeaway: A pilot study evaluated the safety and efficacy of deep transcranial magnetic stimulation (dTMS) in adolescents with treatment-resistant depression (TRD). Out of 15 participants, 14 completed the treatment, showing significant improvements in depression symptoms. While one participant experienced a convulsive syncope, the overall side effects were mild, indicating dTMS may be a viable option for adolescent TRD.
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POSITIVE FACTORS

  • dTMS showed significant improvement in depression symptoms.
  • The treatment was well-tolerated with only mild side effects.
  • Preliminary evidence suggests dTMS is safe for adolescents.

CONCERNS & RISKS

  • One participant experienced convulsive syncope.
  • Limited sample size may affect the generalizability of results.

Full Press Release Details

Background:
Transcranial magnetic stimulation (TMS) is an intervention for treatment-resistant depression (TRD) that modulates neural activity. Deep TMS ( dTMS ) can target not only cortical but also deeper limbic structures implicated in depression. Although TMS has demonstrated safety in adolescents, dTMS has yet to be applied to adolescent TRD.
Objective:
This pilot study evaluated the safety, tolerability, and clinical effects of dTMS in adolescents with TRD. We hypothesized dTMS would be safe, tolerable, and efficacious for adolescent TRD.
Methods:
15 adolescents with TRD completed a six-week daily dTMS protocol targeting the left dorsolateral prefrontal cortex (BrainsWay H1 coil, 30 sessions, 10 Hz, 3.6 s train duration, 20s inter-train interval, 55 trains; 1980 total pulses per session, 80 % to 120 % of motor threshold). Participants completed clinical, safety, and neurocognitive assessments before and after treatment. The primary outcome was depression symptom severity measured by the Children’s Depression Rating Scale-Revised (CDRS-R).
Results:
14 out of 15 participants completed the dTMS treatments. One participant experienced a convulsive syncope; the other participants only experienced mild side effects (e.g., headaches). There were no serious adverse events and minimal to no change in cognitive performance. Depression symptom severity significantly improved pre- to post-treatment and decreased to a clinically significant degree after 10 treatment sessions. Six participants met criteria for treatment response.
Conclusions:
These findings provide preliminary evidence that dTMS may be tolerable and associated with clinical improvement in adolescent TRD.
Full Publication:

Frequently Asked Questions

What is the objective of the dTMS study?

The study aimed to evaluate the safety, tolerability, and clinical effects of dTMS in adolescents with treatment-resistant depression.

How many adolescents participated in the dTMS study?

A total of 15 adolescents with treatment-resistant depression participated in the study.

What were the results of the dTMS treatment?

The results showed significant improvement in depression symptoms, with 6 participants meeting treatment response criteria.

Were there any serious side effects reported?

There were no serious adverse events, though one participant experienced convulsive syncope.

How was the effectiveness of dTMS measured?

Effectiveness was measured using the Children's Depression Rating Scale-Revised (CDRS-R) before and after treatment.

Last updated: Jun 17, 2024