Clinical outcomes following five-day accelerated intermittent theta burst stimulation for treatment-resistant depression in routine clinical practice: A prospective naturalistic cohort study

Published October 15, 2026. A five-day accelerated schedule was feasible in routine care and symptom scores improved through two months, but the uncontrolled study cannot show that stimulation caused the changes.

Khanna A, Espiritu A, Zhu L, Blair M, Giovannetti O, Abate A, Knight J, Deutsch L, Waxman R, Burhan AM.
CNS Spectrums · Publication date: 2026-10-15
Added to site: 2026-10-16
DOI: 10.1017/s1092852926101205

First published online October 15, 2026.

Modalities

TMS

Clinical focus

Treatment-resistant depression, Accelerated iTBS, Routine clinical practice

Population

Adults with treatment-resistant major depressive disorder or bipolar II disorder

Sample

46 participants with longitudinal data; mean age 44.3 years and 54.4% male

Intervention / method

Thirty iTBS sessions of 600 pulses each over five days, separated by 50-minute intervals, with post-treatment and two-month follow-up.

Comparator

No sham or untreated control group

Clinician summary

HAMD-17 response was 28.3% post-treatment and 37.0% at two months; remission was 26.1% and 32.6%. PHQ-9 and GAD-7 also improved. Transient, non-serious stimulation-site pain was the most common adverse event.

How to interpret the findings

Single-center open-label cohort without sham, no randomized efficacy estimate, 46 participants and only two months of follow-up. Bipolar II and major-depression participants were combined.

Equipment and disclosures

The abstract did not identify a verified device manufacturer. No BrainMaster attribution.

Funding and conflicts were not available in the checked abstract. No correction, retraction or concern relation appeared in the Crossref record; this is a bounded check. AI-assisted review.

Related evidence

Compare findings from the same clinical area, including mixed results.

• Latent class modeling of repetitive transcranial magnetic stimulation response trajectories in treatment-resistant depression · Positive with limitations
• Effectiveness of rTMS vs. Pharmacotherapy in Late-Life Treatment-Resistant Depression: An Observational Study of Individual Participant Data From Two Randomized Clinical Trials · Positive with limitations
• Right putaminal gray matter change tracks psychomotor recovery after accelerated iTBS in melancholic treatment-resistant depression · Mixed
• Excitation-Inhibition Balance and Fronto-Limbic Connectivity Distinguish TMS Treatment Outcomes in Refractory Depression · Positive with limitations
• Use of neurostimulation in patients with treatment-resistant depression: current options and future directions. · Positive with limitations
• Pilot randomized trial of intermittent theta-burst stimulation versus H-Coil transcranial magnetic stimulation for treatment-resistant depression. · Positive with limitations