Theta-burst stimulation (TBS)—a form of transcranial magnetic stimulation—is effective and well-tolerated in adults with late-life depression, though the benefits appear to take longer than in younger adults, according to a
study published today in
The American Journal of Psychiatry.
Why It’s Relevant
TBS is a newer stimulation protocol that can deliver therapeutic bursts of magnetic energy to the brain in just a
few minutes per session, enabling accelerated treatment schedules that may hasten depression recovery. TBS data on geriatric patients is limited, however, as older adults are often excluded from clinical trials. As late-life depression is considered a
distinct entity, studies tailored to this population are needed.
By the Numbers
- Researchers recruited 108 adults (average age 67) to receive active or sham TBS. Both groups received brief stimulation to each side of the brain over 20 consecutive weekdays, followed by three booster sessions at weeks six, eight, and 12.
- At six weeks, average Hamilton Depression Rating Scale (HAM-D) scores dropped by 8.5 points in the active TBS group and 7 points in the sham group—which fell short of being statistically significant. At 12 weeks, HAM-D scores dropped by 9.3 points in the active group versus 7.4 points in the sham group—which was significant.
- Participants receiving active TBS were more likely to achieve a clinical response (≥50% reduction in HAM-D score) than those receiving sham TBS at 12 weeks: 52% versus 29%, respectively.
- The most common side effects of TBS were headache and scalp discomfort, with rates similar between the active and sham groups.
The Other Side
The study didn’t meet its desired outcome of demonstrating TBS efficacy within six weeks. The researchers noted that for simplicity, they targeted the same brain regions in every participant whereas advanced TBS approaches use brain imaging to personalize the target, which has shown to improve outcomes. Extending the initial treatment phase beyond 20 sessions may have also improved efficacy.
The Takeaway Message
“Although short-term effects may appear limited, the improvement at week 12 might indicate a delayed neuroplastic trajectory [in older adults], consistent with prior TBS studies,” the researchers wrote. “These exploratory findings warrant additional trials for confirmation and optimized or accelerated protocols to potentially enhance efficacy.”
Related Information
Source
Leandro da Costa Lane Valiengo, et al. Bilateral theta-burst stimulation of dorsolateral prefrontal cortex regions for late-life depression: a randomized, sham-controlled clinical trial. The American Journal of Psychiatry. Published March 11, 2026. doi: 10.1176/appi.ajp.20250537
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