Home-use TES with PlatoWork: a promising solution for TMS maintenance therapy
Are you a TMS provider, looking for a sustainable at-home alternative to supplement your TMS service and to finally solve the problem of continuation and maintenance therapy?
Based on the clinical efficacy of TES for treating depression, as reported in the literature (Lefaucher et al., 2017, Fregni et al., 2021), the PlatoWork headset is a promising tool to complement a successful TMS (or psychotherapy) treatment in order to maintain mental health and prevent or delay relapse of your patients.
Depression patients can be treated with a variety of clinically effective therapies including pharmacotherapy, psychotherapy, and also with TMS - transcranial magnetic stimulation (Lefaucher et al., 2020).
These effective interventions have been shown to significantly improve clinical symptoms and even lead to full remission in ca 70% of patients (cumulative remission rate 67%; Rush et al., 2006). However, once therapy is discontinued, many patients face a significant risk of depressive relapse or recurrence (Craighead & Dunlop, 2014; Judd et al., 2016). In fact, without Continuation or Maintenance Therapy, the probability of a relapse is extremely high.
One approach to tackle this relapse problem is to offer maintenance TMS treatment for relapse prevention. Patients are asked to revisit the clinic to receive follow up TMS treatments at a longer time interval (e.g. 1/month) or to come back to receive regular booster TMS sessions (Rachid, 2018). However, no consensus has been established yet regarding an effective TMS maintenance protocol. Also, this form of maintenance requires patients to travel and visit the clinic to receive brain stimulation regularly and continuously. This has been shown to be unfeasible, undesired and unsustainable for many patients.
How can PlatoWork TES compliment TMS maintenance therapy?
TES is another form of noninvasive transcranial brain stimulation and is considered a clinical alternative for TMS. Instead of magnetic pulses, TES uses a low-intensity electric current to stimulate the brain with a device that is portable and easy to use. TES has proved to be very safe and tolerable without any notable adverse effects.
In contrast to TMS, TES is simple to use, fully operational from a smartphone, and it can easily be operated by patient themselves in their home environment.
We believe that at-home use TES, integrated into a 100% safe and secure remote cloud-based digital monitoring system – aimed at assisting, not replacing, the therapist – is the best solution for addressing the large problem of maintenance in depression therapy.
PlatoScience Medical has developed a simple to use headset capable of applying the evidence-based clinically effective TES depression protocol, easily operated from a user-friendly smartphone app. The patient and clinician have full access to monitor treatment compliance and efficacy. The headset is registered as medical device Class I under the EU MDD.
Help us learn more
To better understand the challenges and opportunities with TMS maintenance, we are currently performing a survey amongst TMS practitioners. We invite (prospective) TMS practitioners, to answer 5 very short multiple-choice questions (1 minute) as part of the survey. In exchange, we will share the results from the survey with all participants. Thank you!
If you have any questions, please reach out:
Morten Gørtz Jønsson
Prof. Alexander Sack, PhD
- Craighead, W. E., & Dunlop, B. W. (2014). Combination psychotherapy and antidepressant medication treatment for depression: for whom, when, and how. Annual review of psychology, 65, 267-300.
- Fregni, F., El-Hagrassy, M. M., Pacheco-Barrios, K., Carvalho, S., Leite, J., Simis, M., ... & Brunoni, A. R. (2021). Evidence-based guidelines and secondary meta-analysis for the use of transcranial direct current stimulation in neurological and psychiatric disorders. International Journal of Neuropsychopharmacology, 24(4), 256-313.
- Judd, L. L., Schettler, P. J., Rush, A. J., Coryell, W. H., Fiedorowicz, J. G., & Solomon, D. A. (2016). A new empirical definition of major depressive episode recovery and its positive impact on future course of illness. The Journal of Clinical Psychiatry, 77(8), 11346.
- Lefaucheur, J. P., Antal, A., Ayache, S. S., Benninger, D. H., Brunelin, J., Cogiamanian, F., ... & Paulus, W. (2017). Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clinical Neurophysiology, 128(1), 56-92.
- Lefaucheur, J. P., Aleman, A., Baeken, C., Benninger, D. H., Brunelin, J., Di Lazzaro, V., ... & Ziemann, U. (2020). Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014–2018). Clinical neurophysiology, 131(2), 474-528.
- Rachid, F. (2018). Maintenance repetitive transcranial magnetic stimulation (rTMS) for relapse prevention in with depression: A review. Psychiatry Research, 262, 363-372.
- Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., ... & Fava, M. (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR* D report. American Journal of Psychiatry, 163(11), 1905-1917.