Improving Transcranial Magnetic Stimulation (TMS) treatment for depression
Publication Date
July 31, 2026
Creator
Yue, Peng
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique with proven efficacy for treating depression. However, its effects are limited by individual and condition-related heterogeneity, leading to unsatisfactory outcomes in many cases. As most patients only begin TMS after unsuccessful pharmacological and/ or psychotherapeutic treatments, there is an urgent need to improve TMS outcomes. To address this issue, this thesis investigates ways to improve TMS treatment and consists of the following two parts. (1) A scoping review of augmentation strategies for TMS in depression. We conducted a comprehensive literature search for tested additional interventions alongside a TMS course. Following data extraction and quality assessment, two broad categories were identified including additional non-invasive neuromodulation techniques (including additional TMS) and additional non-neuromodulation approaches. Despite high heterogeneity of study design and treatment parameters, some strategies stood out with early-evidence efficacy. Suggestions were made as to clinical implications and future research directions. (2) A feasibility pilot study testing a dual neuromodulation approach synchronising TMS pulses to peak waves of transcranial alternating current stimulation (tACS). We specifically tested a newer form of repetitive TMS called intermittent theta burst stimulation (iTBS) and thus termed the dual technique “tsiTBS”. This pilot study expanded on a prior study in healthy participants and confirmed the feasibility of multi-session tsiTBS in a patient group of mild-to-moderate depression. Consistent with previous findings, participants showed a more positive shift in emotional bias following the tsiTBS compared to iTBS alone, indicating possible enhanced antidepressant efficacy. In addition, the tsiTBS had generally good acceptability as revealed by interview data and self-reported side-effect measures.
Item Type
ethesis
Thesis Type
MRes
Supervisors
Subjects (LC)
Associated Schools / Departments
School of Medicine
eprints ID
83014
UoN Repository URI
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YP 20309903 MRes thesis - corrected.pdf
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