{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:59:59Z","timestamp":1785459599317,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["1UG3MH141096\u201001"],"award-info":[{"award-number":["1UG3MH141096\u201001"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n \n When depressive symptoms return after an initial response to transcranial magnetic stimulation (TMS), evidence to guide use of a second acute course is strikingly limited. We aimed\n t<\/jats:bold>\n o estimate how often and how quickly patients with recurrent major depressive disorder benefit from a second course of transcranial magnetic stimulation after they previously improved with TMS.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort study across 20 outpatient centres included 259 patients who received \u2265\u20092 TMS courses between January 1, 2023 and October 1, 2025, and had clinically significant depressive symptoms at the start of course 2; 177 prior responders formed the primary cohort. Treatment used standard 10\u2010Hz left dorsolateral prefrontal cortex TMS. Response and remission were assessed using the PHQ\u20109 and\/or BDI\u2010II; response was defined as a \u2265\u200950% reduction and remission as PHQ\u20109\u2009\u2264\u20094 and\/or BDI\u2010II \u2264\u20099. Symptom change from baseline to end of course 2 and time to first response by session were compared between courses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among past responders, 146 of 177 patients (82.5%; 95% CI, 76.1%\u201387.8%) responded again during course 2 and 96 of 177 (54.2%; 95% CI, 46.6%\u201361.7%) achieved remission. PHQ\u20109 scores decreased by a median of 65.0% (\n p<\/jats:italic>\n \u2009<\u20090.001), and BDI\u2010II scores decreased by a mean of 12.0 points (95% CI, \u221214.0 to \u221210.0;\n p<\/jats:italic>\n \u2009<\u20090.001). Among responders, the first session meeting response criteria occurred earlier during retreatment than during the initial course on both PHQ\u20109 (median session, 12 vs. 16; hazard ratio\u2009=\u20091.40, 95% CI, 1.14\u20131.72;\n p<\/jats:italic>\n \u2009=\u20090.001) and BDI\u2010II (13.5 vs. 22.5; hazard ratio\u2009=\u20091.46, 95% CI, 1.07\u20132.00;\n p<\/jats:italic>\n \u2009=\u20090.018).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Most patients who previously benefited from acute TMS improved again when symptoms recurred, and among responders, the first session meeting response criteria often occurred earlier during retreatment than during the initial course.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/acps.70130","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:30:06Z","timestamp":1785457806000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcranial Magnetic Stimulation Retreatment for Recurrent Depression: A Large Real\u2010World Multisite Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-9754","authenticated-orcid":false,"given":"Stanley","family":"Lyndon","sequence":"first","affiliation":[{"name":"Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Psychiatry Mass General Brigham Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1724-6897","authenticated-orcid":false,"given":"Jason B.","family":"Gibbons","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts 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