Feasibility, tolerability, and preliminary efficacy for non-invasive neuromodulation of the anterior cingulate cortex for depression (NNACC-D) in older adults using deep transcranial magnetic stimulation with an accelerated intermittent theta burst protocol

BMS - Baycrest Medical Services AFP Association

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Feasibility, tolerability, and preliminary efficacy for non-invasive neuromodulation of the anterior cingulate cortex for depression (NNACC-D) in older adults using deep transcranial magnetic stimulation with an accelerated intermittent theta burst protocol

Proposal Abstract

One in five community-dwelling older adults and up to 30% of nursing home residents suffer from clinically-significant depressive illnesses. Approximately 1/3rd fail to respond to any antidepressant medication. Non-invasive brain stimulation therapies using transcranial magnetic stimulation (TMS) are available for depression, although much of the previous research has focused on younger, non-geriatric, clinical populations. This study examines the feasibility and early evidence of the impact of TMS of a novel target, the anterior cingulate cortex (ACC), on depression symptoms in older adults who are unable to tolerate or who have failed to improve with antidepressant medication therapies. TMS will be delivered using an accelerated intermittent theta burst protocol which reduces the time frame of treatment to 1 week only, compared to the standard 4-6 week time frame. In addition, this study will identify potential markers of positive outcomes to TMS for depression in older adults to better understand which patients will benefit most from this therapy. This work is a first step towards a future clinical trial to develop personalized neurostimulation therapies based on TMS of ACC for treatment-resistant depression in older adults.

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