Pilot randomized trial of intermittent theta-burst stimulation versus H-Coil transcranial magnetic stimulation for treatment-resistant depression.

Both stimulation approaches were associated with symptom improvement, and this small pilot found no clear difference between them. The result mainly supports a larger head-to-head trial.

Desbeaumes Jodoin V, Bousseau E, Trottier-Duclos F, Jutras-Aswad D, Lespérance F, Assi ÉB, Nguyen DK, Blumberger DM, Baker TE, Arns M, Daskalakis ZJ, Lespérance P, Miron JP.
Psychiatry research · Publication date: 2026-06-11
Added to site: 2026-10-07
DOI: 10.1016/j.psychres.2026.117274

First published online June 11, 2026; the October issue date is later. Added October 7, 2026 as a historical addition.

Modalities

TMS/rTMS, iTBS

Clinical focus

Treatment-resistant depression, Comparative neuromodulation

Population

Adults with treatment-resistant depression

Sample

28 randomized; 25 completed all 30 sessions

Intervention / method

Six weeks of figure-8-coil iTBS to dorsolateral prefrontal cortex or H7-coil rTMS to dorsomedial prefrontal cortex; outcomes followed through week 18

Comparator

Figure-8-coil iTBS, n=15, versus H7-coil rTMS, n=13

Clinician summary

Adjusted week-six HRSD-17 scores did not differ, with mean difference -0.40, 95% CI -5.23 to 4.43. Response was 40% versus 50%, and remission was 20% in both groups.

How to interpret the findings

Small pilot without sham or usual-care control. Coil type and cortical target differed together, limiting attribution to pulse pattern alone. Three participants did not complete all sessions, safety results were unavailable in the abstract, and exploratory cognitive associations were not confirmed in adjusted models.

Equipment and disclosures

Figure-8 coil for iTBS and H7 coil for deep rTMS; specific stimulator models were not verified from the checked abstract.

Canadian Institutes of Health Research support is indexed. Authors disclosed relationships involving BrainsWay, MagVenture, Sooma Medical, Sama Therapeutics, Salma Health, Synaeda Therapeutics, the Clinical TMS Society and other organizations; the complete indexed statement is retained in the PubMed snapshot.

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