EC Clinical and Medical Case Reports

Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved modality for treatment-resistant major depressive disorder (MDD). This case report aims to explore the therapeutic outcomes of rTMS in a patient with multiple co-occurring non-psychiatric diseases, including heart failure, renal disease, type 2 diabetes, and human immunodeficiency virus (HIV) infection. Quantitative psychometric assessments were administered weekly via PHQ-9 (Patient Health Questionnaire-9) and GAD-7 (Generalized Anxiety Disorder 7-item scale), which revealed symptom reduction by more than 50% by midpoint of treatment (week 5), and more than 80% improvement from week 6 onward. Quality of life improvements such as improved diet, exercise, ability to function in daily life, and overall sense of well-being were also noted based on weekly administration of the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF). Further, large-scale, randomized and blinded studies are recommended to validate our preliminary observations on the efficacy and safety of rTMS in patients with co-occurring diseases involving moderate to severe multi-organ dysfunction.

 Keywords: Repetitive Transcranial Magnetic Stimulation (rTMS); Dorsolateral Prefrontal Cortex (DLPFC); Neuromodulation; MDD (Major Depressive Disorder); PHQ-9 (Patient Health Questionnaire-9); GAD-7 (Generalized Anxiety Disorder-7 Item Scale); Motor Threshold (MT)

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