iTBS to Relieve Depression and Executive Dysfunction in Older Adults: An Open Label Study

Background: Executive Function Deficits (EFD) accompany depression and are associated with poor outcomes in older adults. We examined whether Intermittent Theta Burst Stimulation (iTBS) could improve depression with EFD. Methods: Thirteen geriatric patients with depression and EFD were enrolled. Open label iTBS was delivered bilaterally over the dorso-lateral-prefrontal-cortex for four weeks. Results: Montgomery Asberg Depression Scale scores improved significantly from baseline to treatment-end, mean change in score = 11.82 points, 95% CI = 8.3, 15.4. The Flanker Inhibitory control and attention test showed significant improvement in executive function from baseline to treatment-end, mean change in score = −7.73, 95% CI ( −13.54, −1.92). Side effects included twitching in facial muscles (n = 11), headaches (n = 10) and stimulation discomfort (n = 4). Limitations: Small sample size and lack of a sham comparator. Conclusion: iTBS improved depression with EFD in older adults. Side effects appeared higher than in previous iTBS studies.