新加坡难治性抑郁症的重复经颅磁刺激：一项回顾性自然研究

BRIEF RESEARCH REPORT article

Front. Psychiatry

Sec. Neurostimulation

• Khoo Teck Puat Hospital, Singapore, Singapore

Abstract

Introduction Naturalistic repetitive transcranial magnetic stimulation (rTMS) outcome data for treatment-resistant depression remain limited in Southeast Asia. This retrospective study describes such outcomes from a general hospital in Singapore. Method 28 outpatients received rTMS (10Hz high-frequency or intermittent theta-burst) targeting the left dorsolateral prefrontal cortex (F3 scalp position) between May 2022 and May 2025. Treatment-resistant depression was defined as failing ≥2 antidepressant classes for ≥6 weeks each. The primary outcome was change in the Montgomery-Åsberg Depression Rating Scale (MADRS) score; secondary outcomes included the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16), the Depression, Anxiety and Stress Scale-21 (DASS-21), the Quality of Life, Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), the Clinical Global Impression-Severity (CGI-S), and the Global Assessment of Functioning (GAF). Results Despite 85.7% of patients having failed ≥3 antidepressant classes, the mean MADRS score decreased by 15.8 (SD 9.1), from 29.6 (SD 7.6) to 13.9 (SD 11.1, p<0.001). This corresponded to a 67.9% response rate and a 57.1% remission rate. All secondary measures (QIDS-SR16, DASS-21, Q-LES-Q-SF, CGI-S, and GAF) showed significant improvements (all p<0.001). Shorter episode duration and higher baseline quality of life were significantly associated with remission. Conclusion We report favourable response (67.9%) and remission (57.1%) rates within a general hospital cohort in Singapore following standardised rTMS targeting the left dorsolateral prefrontal cortex (approximated by the F3 position), despite extensive prior antidepressant medication failure. These findings contribute real-world data to the limited Southeast Asian literature on standardised rTMS protocols for treatment-resistant depression in general hospital and similar clinical settings.

Keywords

Major Depressive Disorder, Naturalistic study, Neuromodulation, repetitive transcranial magnetic stimulation, theta-burst stimulation, treatment-resistant depression

Received

30 June 2026

Accepted

16 September 2026

Copyright

© 2026 Tay and Thng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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