Repetitive transcranial magnetic stimulation for treatment resistant depression

The stimulation paradigm varied among studies in terms of the rTMS device used, coil shape, location of the coil on the scalp, frequency and intensity of stimulation, number of trains, train duration, number of sessions, and number of total pulses. [...] Status of Technology in Other Provinces of Canada In two provinces of Canada (Quebec and Saskatchewan), rTMS is an insured service, and in one province (Alberta), the technology is under review by the Expert Advisory Group of the Health Technology Decision Process at the time of writing. [...] We selected the Hamilton Rating Scale for Depression to measure the outcomes of treatment because this scale is the most commonly used tool for clinical assessment of treatments for depression.14 The Hamilton Rating Scale for Depression is a multidimensional and clinician- rated scale that has become the standard for clinical trials of depression. [...] Cohen noted that, with the effect size of 0.2, the two populations will have an overlap of about 85% and the overlap between the two populations will be 67% and 53% for effect sizes of 0.5 and 0.8, respectively. [...] Although the definition of response was consistent among the sham studies (all based on ≥50% reduction in depression scores), the definition of response varied in ECT trials and the definition of remission varied across the studies for both sham trials and ECT trials.