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Can psychological distress be treated with rTMS? First of its kind study shows promising results for palliative patients.


According to a proof-of-concept study published in Palliative Medicine, patients at Bruyère’s academic palliative care unit with advanced illness and psychological distress responded positively to accelerated repetitive transcranial magnetic stimulation (rTMS) treatment.

Five out of six participants experienced more than a 50 percent improvement in depression, anxiety, or both two weeks post-treatment, suggesting rTMS holds promise as a treatment for psychological distress in patients with advanced illness.

Psychological and existential distress affect 35-50% of people with advanced illness as they near the end of life. Therapeutic options in the palliative context remain limited, as pharmacological and psychotherapy interventions often take substantial time to yield results.

Palliative care researchers at Bruyère tested an accelerated five-day therapeutic approach that could help palliative patients with psychological distress.

“Palliative and end-of-life care need to address distress in the same way we address pain and symptom management,” said Dr. James Downar, Investigator with the Bruyère Research Institute and co-chair of the Pan-Canadian Palliative Care Research Collaborative. “This is an important step toward finding effective, scalable, and time-sensitive treatments for patients who are dealing with some of the most distressing moments of their lives.”

rTMS is a non-invasive brain stimulation technique approved for treating major depression, post-traumatic stress disorder, and other mood and anxiety disorders. New accelerated rTMS protocols offer a shorter duration of therapy and close the time gap between treatment and effect, which may be a suitable option for patients when time is of the essence.

This is the first time rTMS has been studied in the treatment of psychological distress in a palliative setting.

"This was a small study, so our next step is to conduct a randomized sham-controlled clinical trial with more patients to test how effective accelerated rTMS is in treating psychological distress," said Dr. Downar.

With portable rTMS devices in development, it opens the possibility of facilitating community-based treatment for those who are receiving care in their homes.


This research was funded by an Innovation Grant from the Canadian Cancer Society and the Lotte and John Hecht Memorial Foundation.