Annually, about 1 in 12 adults suffer from a
depressive episode. Not all patients with depression respond to treatment with medication. rTMS (repetitive transcranial magnetic stimulation) is an effective treatment option for these patients with difficult-to-treat depression. Unfortunately, not everyone responds to treatment with rTMS either and more effective treatment is necessary.
rTMS is a form of non-invasive brain stimulation that uses
uses magnetic pulses that can pass through the skull.
By delivering these pulses repeatedly (repetitively), we can make the activity of specific brain areas to increase or decrease. iTBS (intermittent theta burst stimulation) is a form of rTMS that uses periodic (intermittent), rapidly successive impulses (theta bursts) can stimulate more stimulate more in a shorter time.
In the D-DOTT study we compare the (cost-) effectiveness of the standard rTMS protocol and an accelerated iTBS protocol for the treatment of depressive symptoms. Both protocols involve an active, intensive treatment, but differ in important aspects. The protocols are explained below:
1. The accelerated iTBS protocol consists of a 5-day, 10-times-a-day stimulation with iTBS. Stimulation occurs once an hour and lasts 10 minutes per session. The stimulation site is determined using (f)MRI.
2. The standard rTMS protocol consists of a 6-week, daily treatment with rTMS. Stimulation takes place from Monday to Friday and lasts approximately one half hour. The stimulation site is determined using head measurements.
