A recent systematic meta-analysis study by Shen and Fang (August 2024) published in the British Journal of Hospital Medicine ( https://www.magonlinelibrary.com/doi/full/10.12968/hmed.2024.0157 ) shows comparable efficacy (remission or response rate) and safety of iTBS and rTMS treatment for patients with depression and both treatment protocols significantly better than sham treatment. But a nuanced understanding is important for clinical application and personalised TMS treatment for depression. It is possible that one protocol might be better over another protocol for some individuals. In this context, Slan et al. (August 2024 : https://doi.org/10.1016/j.jad.2024.08.129) published research in the Journal of Affective Disorders is worthy of consideration. In their retrospective naturalist treatment study based on 414 patients they show that iTBS was less efficacious in males than females and 10 Hz rTMS was more efficacious in patients over the age of 50.
In summary:
- Generally both the iTBS and 10 Hz rTMS have comparable efficacy
- 10 Hz rTMS protocol should be preferred for females and patients over 50 years of age.
Figure below from Slan et al. (2024)
