Home-use TES: 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), we are confident that at-home TES is the perfect tool to complement a successful TMS (or psychotherapy) treatment in order to maintain mental health and prevent or delay relapse of your patients. 

Before offering this to a wider audience, we are inviting (prospective) TMS practitioners such as yourself, to answer 5 very short multiple-choice questions (1 minute) to assess the interest in this non-pharmacological maintenance therapy solution for your patients.

As part of this selected group, completing this short survey (literally 5 clicks) will provide you with the option to participate in a multi-clinic study to evaluate the feasibility and clinical efficacy of at-home TES depression maintenance therapy. This includes all necessary support to avoid any burden or extra work on your end and is of course fully optional and tailored to your needs and interests.

As a participant, you are entitled to:

  • Receive the CE marked PlatoScience Medical TES (tDCS) headsets at a non-profit cost
  • Full support in data collection and analyses to evaluate the efficacy of this relapse prevention for your patients
  • The opportunity to be included as a co-author on a potential publication of the merged findings of this international study

In case you find this service helpful, you will remain a prioritized partner also beyond the duration of this trial.


If you have any questions, please reach out:

Morten G Joensson

Morten Gørtz Jønsson
Research Manager

Alexander T. Sack

Prof. Alexander Sack, PhD
Scientific Advisor

 

Background and additional reading 

Depression patients can be treated with a variety of clinically effective therapies including pharmacotherapy, psychotherapy, and also with transcranial magnetic stimulation (TMS) (Lefaucher, 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 relapse is almost 90%. 

One approach to tackle this relapse problem is to offer, e.g. 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.

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 the patient himself in his home environment (at-home use TES headset).

According to recent EU recommendations (Lefaucher et al., 2017; 2020), TES has now reached level B evidence (probably effective), and according to US experts (Fregni et al., 2021) even level A evidence (definitely effective) for treating depression. Importantly, in contrast to TMS, TES is much simpler to use, fully operationally from a smartphone, and it can be operated by the patient himself in his home environment (at-home use TES).

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 app on a smartphone. The patient and clinician have full access to monitor treatment compliance and efficacy. The headset is approved as a medical device with CE mark (EU).

References

  • Craighead WE, & Dunlop BW (2014). Combination psychotherapy and antidepressant medication treatment for depression: For whom, when, and how. Annual Review of Psychology, 65(1), 267–300. 10.1146/annurev.psych.121208.131653 [PubMed] [CrossRef] [Google Scholar]
  • Fregni F, et al. Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders. Int J Neuropsychopharmacol. 2021 Apr 21;24(4):256-313. doi: 10.1093/ijnp/pyaa051. PMID: 32710772; PMCID: PMC8059493.
  • Judd LL, Schettler PJ, Rush AJ, Coryell WH, Fiedorowicz JG, & Solomon DA (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), 1065–73. 10.4088/JCP.15m09918. [PubMed] [CrossRef] [Google Scholar]
  • Lefaucheur JP, et al. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol. 2017 Jan;128(1):56-92. doi: 10.1016/j.clinph.2016.10.087. Epub 2016 Oct 29. PMID: 27866120.
  • Lefaucheur, J. P. et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018). Clinical Neurophysiology vol. 131 474–528 (2020).
  • Rush, A. J. et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. Am. J. Psychiatry 163, 1905–1917 (2006).
  • Rachid F. Maintenance repetitive transcranial magnetic stimulation (rTMS) for relapse prevention in with depression: A review. Psychiatry Res. 2018 Apr;262:363-372. doi: 10.1016/j.psychres.2017.09.009. Epub 2017 Sep 19. PMID: 28951141.