The durability of response to transcranial magnetic stimulation in veterans with major depressive disorder
Abstract
Background Transcranial Magnetic Stimulation (TMS) has established efficacy for treatment resistant major depressive disorder (MDD-TR). Information on the durability of response to TMS for MDD-TR, particularly in the Veteran population, is limited. The current study aimed to address this gap in the literature by examining the durability of response to TMS for MDD-TR in Veterans.Methods Retrospective cohort analysis examining Veterans receiving TMS treatment for MDD-TR at a large academic VA medical center. For the primary endpoint, a composite marker termed Significant Psychiatric Events Associated with Relapse (SPEAR) consisting of mental health hospitalization, suicide attempt, death by suicide, or requirement for additional neuromodulation interventions, was utilized to assess relapse. Secondary endpoints included examining post-TMS changes in psychopharmacological regimens as a marker for relapse. Associations between covariates of interest and improved durability of response were analyzed.Results Study cohort consisted of 217 Veterans, of whom 159 had the required assessments and were included in analyses. TMS was shown to be a durable treatment for MDD-TR with 84.73 % of TMS responders having at least a 2-year period post TMS treatment without significant relapse as defined by SPEAR. 35.4 % of responders were found to have at least a 2-year period without requirements for changes to their psychopharmacological regimens. No covariates analyzed were associated with differences in TMS durability.Conclusions Results indicate that TMS produces a durable response in Veterans with MDD-TR when measured by markers of severe relapse. Prospective studies analyzing different markers of relapse and larger sample sizes are needed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The second criterion with which most authors agree is antidepressant treatment, with some mentioning it in general and others specifying change, upward adjustment, review, or potentiation.
“The second criterion with which most authors agree is that related to antidepressant treatment, although some mention it in general (27, 33) and others specify whether they consider a change of antidepressant (8, 15, 26, 34, 40, 42, 48, 50), an upward adjustment (10, 17, 40, 45), a review of the treatment (24) or a potentiation (17).”
From Administrative criteria in the relapse of depressive disorder: a critical appraisal (2026) · cites this paper as [50]
Cites
A new depression scale designed to be sensitive to change
Montgomery, S. A., & Åsberg, M. (1979) · British Journal of Psychiatry · doi:10.1192/bjp.134.4.382 · Cited by 13,962 · see citing works
Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., Niederehe, G., Thase, M. E., Lavori, P. W., Lebowitz, B. D., et al. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.11.1905 · Cited by 5,643 · see citing works
O’Reardon, J. P., Solvason, H. B., Janicak, P. G., Sampson, S., Isenberg, K. E., Nahas, Z., McDonald, W. M., Avery, D., Fitzgerald, P. B., Loo, C., et al. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.01.018 · Cited by 1,910 · see citing works
The Economic Burden of Adults With Major Depressive Disorder in the United States (2005 and 2010)
Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09298 · Cited by 1,779 · see citing works
Blumberger, D. M., Vila-Rodriguez, F., Thorpe, K. E., Feffer, K., Noda, Y., Giacobbe, P., Knyahnytska, Y., Kennedy, S. H., Lam, R. W., Daskalakis, Z. J., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30295-2 · Cited by 1,363 · see citing works
Limitations of Diagnostic Criteria and Assessment Instruments for Mental Disorders
Regier, D. A., Kaelber, C. T., Rae, D. S., Farmer, M. E., Knaüper, B., Kessler, R. C., & NORQUIST, G. S. (1998) · Archives of General Psychiatry · doi:10.1001/archpsyc.55.2.109 · Cited by 549 · see citing works
Transcranial Magnetic Stimulation in the Treatment of Depression
Gershon, A. A., Dannon, P. N., & Grunhaus, L. J. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.5.835 · Cited by 530 · see citing works
The Economic Burden of Adults with Major Depressive Disorder in the United States (2019)
Greenberg, P., Chitnis, A., Louie, D., Suthoff, E., Chen, S.-Y., Maitland, J., Gagnon-Sanschagrin, P., Fournier, A.-A., & Kessler, R. C. (2023) · Advances in Therapy · doi:10.1007/s12325-023-02622-x · Cited by 223 · see citing works
Of sound mind and body: depression, disease, and accelerated aging
Wolkowitz, O. M., Reus, V. I., & Mellon, S. H. (2011) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2011.13.1/owolkowitz · Cited by 213 · see citing works
Janicak, P. G., Nahas, Z. H., Lisanby, S. H., Solvason, H. B., Sampson, S. M., McDonald, W. M., Marangell, L. B., Rosenquist, P. B., McCall, W. V., Kimball, J. N., et al. (2010) · Brain stimulation · doi:10.1016/j.brs.2010.07.003 · Cited by 170 · see citing works
de Jong, M., van der Worp, H. B., van der Graaf, Y., Visseren, F. L. J., & Westerink, J. (2017) · Cardiovascular Diabetology · doi:10.1186/s12933-017-0617-4 · Cited by 132 · see citing works
Hunter, A. M., Minzenberg, M., Cook, I. A., Krantz, D. E., Levitt, J. G., Rotstein, N. M., Chawla, S. A., & Leuchter, A. F. (2019) · Brain and Behavior · doi:10.1002/brb3.1275 · Cited by 120 · see citing works
Senova, S., Cotovio, G., Pascual‐Leone, Á., & Oliveira-Maia, A. J. (2018) · Brain stimulation · doi:10.1016/j.brs.2018.10.001 · Cited by 117 · see citing works
Retrospective Studies: A Review for the Clinician
Sartwell, P. (1974) · Annals of Internal Medicine · doi:10.7326/0003-4819-81-3-381 · Cited by 82 · see citing works
Patalay, P., & Fried, E. I. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13333 · Cited by 79 · see citing works
Richieri, R. M., Guedj, É., Michel, P., Loundou, A., Auquier, P., Lançon, C., & Boyer, L. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.05.062 · Cited by 73 · see citing works
Citrome, L., Jain, R., Tung, A., Landsman-Blumberg, P. B., Kramer, K. L., & Ali, S. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.01.044 · Cited by 67 · see citing works
Depression in Gulf War veterans: a systematic review and meta-analysis
Blore, J. D., Sim, M. R., Forbes, A. B., Creamer, M. C., & Kelsall, H. L. (2015) · Psychological Medicine · doi:10.1017/s0033291714001913 · Cited by 62 · see citing works
Carpenter, L. L., Aaronson, S., Hutton, T. M., Mina, M., Pages, K. P., Verdoliva, S., West, W. S., & Sackeïm, H. A. (2020) · Brain stimulation · doi:10.1016/j.brs.2020.12.003 · Cited by 61 · see citing works
Epidemiology of pharmaceutically treated depression and treatment resistant depression in Taiwan
Fife, D., Feng, Y., Wang, M. Y.-H., Chang, C., Liu, C.-Y., Juang, H.-T., Furnback, W. E., Singh, J. B., & Wang, B. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.03.006 · Cited by 55 · see citing works
Madore, M. R., Kozel, F. A., Williams, L. M., Green, L. C., George, M. S., Holtzheimer, P. E., Yesavage, J. A., & Philip, N. S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.025 · Cited by 50 · see citing works
Wilson, S., Croarkin, P., Aaronson, S., Carpenter, L., Cochran, M., Stultz, D., & Kozel, F. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.09.040 · Cited by 27 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Administrative criteria in the relapse of depressive disorder: a critical appraisal
Bernal-Cueto, S., Cegla-Schvartzman, F., & Baca-García, E. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1796386
“…authors agree is that related to antidepressant treatment, although some mention it in general (27, 33) and others specify whether they consider a change of antidepressant (8, 15, 26, 34, 40, 42, 48, 50), an upward adjustment (10, 17, 40, 45), a review of the treatment (24) or a potentiation (17).”
- Authors
- Lisha, I., Godbole Kroger, N. B., Tsalatsanis, A., Norred, M. A., Daneman, L. E. W., Tindall, B., Grewal, E. P., Araque, S. M., & Zuschlag, Z. D.
- Affiliations
- University of South Florida (US)
- James A. Haley Veterans' Hospital (US)
- Harvard University (US)
- Corresponding author
- Zuschlag, Zachary D.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2026-04
- Volume
- 399
- Pages
- 121032
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W7117354964
- Cited by
- 1
- References
- 22
- Citations by year
- 2026: 1
- FWCI
- 0.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- James A. Haley Veterans' Hospital
- U.S. Department of Veterans Affairs
- National Institutes of Health
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- transcranial magnetic stimulation, veterans, relapse, suicide, psychiatric hospitalization, neuromodulation
- MeSH terms
- Adult, Aged, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Suicide, Attempted, Veterans, Treatment Outcome, Transcranial Magnetic Stimulation, Depressive Disorder, Treatment-Resistant
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
