Study Explores Core Elements of Accelerated TMS for the Treatment of MDD


Researchers focused on elements across several categories, including brain state, cumulative exposure, and treatment and individualized parameters.



Researchers reviewed treatment parameters, cumulative exposure, individualized parameters, and brain state associated with accelerated transcranial magnetic stimulation (TMS) for the treatment of major depressive disorder (MDD).

As an emerging application of traditional TMS, accelerated TMS aims to improve patient response time and reduce treatment length. However, research on accelerated TMS is very early in development, and the procedure has only a few protocols that vary significantly and have not yet been standardized. The authors aimed to explore accelerated TMS more in-depth to assess its promise as a future treatment for MDD. To this end, they reviewed 9 core elements across 4 categories that should be considered in accelerated TMS protocol.1

The first category, treatment parameters, included frequency and inter-stimulation interval. The second category, cumulative exposure, included number of treatment days, number of sessions per day, and number of pulses per session. The third category, individualized parameters, included dose and treatment target. And the fourth category, brain state, included concurrent treatments and context.1

With all elements considered, the authors determined that accelerated TMS holds promise for reducing depressive symptoms and treatment times, but more research is needed to identify the ideal protocols for accelerated TMS and to determine the procedure’s future in MDD treatment.1

“Overall, accelerated TMS appears to hold promise to reduce treatment time and achieve rapid reduction in depressive symptoms, but at this time significant work remains to be done,” the authors concluded. “Rigorous clinical trials combining clinical outcomes and neuroscientific measures such as electroencephalogram, magnetic resonance imaging, and e-field modeling are needed to define the future of accelerated TMS for MDD.”1


1. van Rooij SJH, Arulpragasam AR, McDonald WM, Philip NS. Accelerated TMS—moving quickly into the future of depression treatment. Neuropsychopharmacology. 2023.

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