How Do Professionals Measure the Success of TMS Treatment for Depression?

For many people who suffer from depression, finding a truly effective treatment can be a challenge. Transcranial Magnetic Stimulation (TMS) is a great option for many individuals for whom traditional treatments have not worked. How will the treatment team know TMS is helping? There are many rating scales including the Patient Health Questionnaire (PHQ9), the Montgomery-Asberg Depression Rating Scale (MADRAS), the Hamilton Depression Rating Scale (HDRS), and the Beck Depression Inventory (BDI). Keep reading to learn how these measurements can be helpful in measuring TMS success.
Heather Wilson

Heather Wilson

Executive Director at .

Sustained Recovery and Neurocognitive Function Improvements

Unlike acute relief, which is certainly important, long-term maintenance of improved mental health states indicates that TMS has had a profound and lasting effect. It can be measured through regular follow-ups and monitoring relapse rates.

Another metric is the examination of neurocognitive function improvements that can directly correlate with brain areas targeted by TMS. Enhanced cognitive performance post-treatment often suggests that patients are not just feeling better but are also experiencing a tangible improvement in brain function, which underlies their depressive symptoms.

Hamilton Depression Rating Scale and the Beck Depression Inventory

Clinical scales, such as the Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI), are the most widely used scales among clinicians for pre-treatment, mid-treatment, and follow-up evaluations of depression symptom severity. These scales are useful because they standardize data collection related to depressive symptoms, allowing for a reliable and valid assessment of the clinician’s findings.

TMS trials have consistently shown that patients subjectively report that their HDRS scores are markedly reduced; close to 50-60 percent of these patients improve so markedly that they reach clinically meaningful improvements – and roughly one-third reach full remission from their symptoms. This pattern reinforces the growing consensus that tools like HDRS or BDI are good working instruments for doctors who want to monitor their progress against depression objectively at every stage of a treatment intervention.

Kevin Huffman

Kevin Huffman

CEO & Founder of .
Ozan Toy MD, MPH

Ozan Toy MD, MPH

Chief Medical Officer at .

Symptom Questionnaires and Self-Reporting

We often look at the patient’s symptoms which were assessed by the psychiatric interview. Oftentimes, psychiatrists will evaluate changes in mood, behavior, appetite, sleep, and overall function in daily life. To supplement the psychiatric interview, commonly used standardized rating scales such as the Hamilton Rating Scale for Depression (Ham-D) or the Montgomery-Asberg Depression Rating Scale (MADRAS) track changes in specific symptoms related to depression.

Another important aspect is the patient’s feedback and their satisfaction with the treatment. We take into account their personal experience and any changes to their mental health or side effects they experience. Assessing this can be a valuable indicator of the treatment’s success and can also predict whether or not a patient will respond again to a repeat course of TMS if they suffer from a relapse in the future. Research on TMS often looks at long-term outcomes, such as the likelihood of relapse and the need for further treatment to determine the efficacy of TMS for various conditions.

Finally, we also consider the duration and intensity of the treatment parameters for TMS. TMS is typically administered over several weeks, and we monitor the patient’s progress throughout this time. The intensity of the treatment, measured in terms of the strength of the magnetic pulses, can also play a role in its effectiveness.

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