Synergistic Effects of TMS and Meditation: An Observational Study of Patients Practicing Meditation During TMS Sessions

Background: TMS has been proven effective in treating persistent depression, with ongoing efforts to optimize patient outcomes.Meditation has also gained recognition in healthcare as an alternative intervention with benefits in emotion regulation.One patient's remarkable breakthrough by practicing guided meditation during TMS treatments prompted a question of the potential synergistic effects of these two interventions.With limited existing research, we conducted an observational study on patients practicing meditation during TMS sessions.Methods: We studied eight patients with major depressive disorder (MDD) (mean age: 37; 5 male and 3 female) who practiced guided or independent meditation more than 20% of their total TMS sessions (range: 20%-99%).Initial and final BDI-II scores were compared, and their feedback on meditation was reviewed.Results: Significant improvements were found in MDD symptoms, with an average 72% improvement in BDI-II score.All eight patients responded to treatment (defined as > 50% change in BDI).Of the eight, seven patients (87.5%) achieved remission.Discussion: Compared to the standard 67% remission and 40% response rates, our sample patients have shown higher rates of improvement.The patient with the most notable outcome reported that meditation has been very beneficial during his TMS journey, allowing a deeper state of meditation.Of note, two experienced meditators achieved an average 96% improvement in BDI scores.This result may be attributable to meditation's impact on prefrontal areas also targeted by TMS.Further research, with clearer definitions of meditation type and duration, as well as controlled trials, is necessary to confirm the synergistic effects of TMS and meditation.