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Case Report

Application of accelerated continuous theta burst stimulation in treatment-resistant depression

Bibliographic Data

ID15530375
AuthorsGuilan Sun (Third People's Hospital of Huzhou), Zhongxia Shen (0000-0003-3858-4665, Third People's Hospital of Huzhou), Minmin Wang (0000-0003-3213-2481, Zhejiang University of Science and Technology, corresponding author), Xiaomei Zhang (0000-0003-1709-8465, Third People's Hospital of Huzhou, corresponding author)
Year2025
Volume16
Pages1615403-1615403
Publication date2025-10-03
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2025.1615403
PMID41113198
OpenAlexW4414793938
LanguageEN
References cited30

Treatment-resistant depression (TRD) poses a significant challenge in psychiatric practice. While repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive neuromodulation technique for TRD, a subset of patients fails to respond adequately to these traditional rTMS protocols. This case report describes the treatment course of a 53-year-old female patient with a complex psychiatric history. Despite initial successful treatment and remission, the patient experienced a relapse of severe depression characterized by sleep disturbances, anxiety, anhedonia, and suicidal ideation. The patient underwent multiple pharmacological treatments, intermittent theta burst stimulation (iTBS) and electroconvulsive therapy (ECT) with limited success over the course of two years. Subsequently, the patient received accelerated continuous theta burst stimulation (a-cTBS) targeting the right dorsolateral prefrontal cortex (DLPFC). Following a-cTBS treatment (18000 pulses each day for 5 consecutive days), the patient showed significant improvement in depressive and anxiety symptoms, as well as in cognitive functions. Remarkable clinical improvement was observed: the Montgomery Depression Rating Scale score decreased from 32 to 9, the Hamilton Anxiety Rating Scale score dropped from 20 to 6, and suicidal ideation decreased from 13 to 5, ultimately disappearing. The outcomes of this intervention suggest that a-cTBS may represent a viable alternative for patients with TRD who do not benefit from existing treatment modalities

Anxiety · Brain stimulation · Depression (economics · Electroconvulsive therapy · Neuromodulation · Prefrontal cortex · Rating scale · Stimulation · Transcranial magnetic stimulation · Electroconvulsive Therapy Studies · Transcranial Magnetic Stimulation Studies · Treatment of Major Depression

  • Treatment-resistant or difficult-to-treat depression

    Open Access•Kyriakos Souliotis, Christina Golna et al.•Frontiers in Psychiatry•2025

Citation velocityhistorical
Highly citedNo

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