The American journal of psychiatry
March 11, 2026 · via Europe PMC
Bilateral Theta-Burst Stimulation of Dorsolateral Prefrontal Cortex Regions for Late-Life Depression: A Randomized, Sham-Controlled Clinical Trial.
Valiengo LDCL, Pinto BS, Luethi M, +15 more, Brunoni AR.
AI summary — for doctors, generated from the abstract only
Bilateral theta-burst stimulation did not beat sham at week 6 in late-life depression but did by week 12.
What was studied
Triple-blind sham-controlled RCT of 108 adults aged 60+ with moderate-severe MDD off antidepressants, given 23 sessions of bilateral DLPFC TBS or sham.
Key findings
- Week 6 HAM-D reduction difference -1.65 (95% CI -3.38 to 0.08), not significant
- Week 12 difference -1.89 (95% CI -3.75 to -0.03)
- Response 52% active vs 33% sham at week 12
Clinical relevance
Offers a possible nonpharmacologic option for older adults with depression.
Who should care
Limitations
Primary week-6 comparison was not significant and the week-12 benefit has a borderline confidence interval.
TBS may help late-life depression, though early benefit was not shown.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
The objective of this study was to assess the efficacy of theta-burst stimulation (TBS) in treating late-life depression.
Methods
A triple-blind, sham-controlled randomized clinical trial was performed. The study included participants age 60 and older with a diagnosis of moderate to severe major depressive disorder who were not using antidepressants. Exclusion criteria included other psychiatric disorders, neurological disorders, and contraindications to TBS. TBS was administered bilaterally, with intermittent TBS on the left dorsolateral prefrontal cortex (DLPFC) and continuous TBS on the right DLPFC, with 1,800 pulses at each side. Participants underwent 20 daily sessions of active or sham TBS over 20 consecutive weekdays and one additional session during weeks 6, 8, and 12 (totaling 23 sessions).
Results
A total of 108 participants (mean age, 67 years) were enrolled and underwent either active or sham TBS. In an intention-to-treat analysis, there was no significant difference between groups at week 6 in mean reduction in Hamilton Depression Rating Scale (HAM-D) score (mean difference, -1.65, 95% CI=-3.38, 0.08). By week 12, active TBS was associated with a significantly greater reduction in HAM-D score compared to sham (mean difference, -1.89, 95% CI=-3.75, -0.03), with response rates of 52% in the active group and 33% in the sham group. Linear mixed models analyzing HAM-D score did not show a statistically significant greater reduction in the active TBS group compared to the sham group at week 6 (Cohen's d=-0.36, 95% CI=-0.74, 0.01).
Conclusions
The active TBS group did not have a statistically significant greater reduction in HAM-D scores compared to the sham group at week 6. By week 12, however, active TBS was superior to sham stimulation in reducing depressive symptoms in patients with late-life depression, suggesting TBS as a possible treatment option for this population.
DOI
10.1176/appi.ajp.20250537
PMID
41807319
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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