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President's Message

by: Paul Croarkin, DO, MSc

Greetings colleagues. I hope you had a great summer and are enjoying fall. It certainly has been an active year for our field and society. First, with mixed emotions, I want to express gratitude and celebrate administrative transitions within our society. Marcel Bourdase MPA, CAE has served as the Executive Director of the Clinical TMS Society since 2016. Since that time our growth has been exponential in terms of the quality of our annual meeting, member resources, outreach, and advocacy. Our membership is now over 500 members and 25 countries strong. These milestones are a credit to Marcel’s vigorous efforts, leadership and steady hand. All good things must come to an end and good people have a tendency to get promoted, so we wish Marcel all the best in his new role. Please join me in thanking and congratulating him now and at our annual meeting in February 2019. Mrs. Ashleigh Servadio, MSC assumed the role of Executive Director as of September 1, 2018. We can be confident that the society’s positive trajectory will continue as Ashleigh has a wealth of experience through prior work with both the Clinical TMS Society and the Northern California Psychiatric Society. Please welcome Ashleigh into her new role.

In August 2018, there were 2 new FDA clearances. These watershed events will likely have broad implications for our patients, practices and field. First, the FDA cleared an intermittent theta burst (iTBS) treatment protocol for the MagVita rTMS system in which daily treatment sessions are 3 minutes. This approval was based on a large (n=414) noninferiority clinical trial published in the Lancet in April 2018. This study, spearheaded by Dr. Daniel Blumberger and colleagues, demonstrated that iTBS was non-inferior to standard 10 Hz rTMS for the treatment of depression with a similar tolerability and safety profile. The FDA also cleared the Brainsway deep TMS system for the treatment of obsessive-compulsive disorder (OCD). This clearance was based on a large (n=100) randomized, sham-controlled, multicenter study. Deep TMS was provided adjunctively to existing treatments for OCD. Response was defined as >30% improvement in the Yale-Brown Obsessive Compulsive Scale score. Of the patients receiving active treatment, 38% responded while 11% of those receiving sham responded. Patients receiving the treatment also had symptom provocation prior to each session. This multimodal approach will likely inspire future research designs. Notably, this was a de-novo clearance.

These new approaches present many opportunities, challenges and questions for our practices, society and field. How will this impact TMS practice? When and how do we integrate these approaches into our practices? How will these approaches be reimbursed? How will this impact patient access, reimbursement and psychiatry in general? It will likely take time to discern thoughtful answers to these questions. However, I would encourage a proactive approach for the Clinical TMS Society. We are uniquely poised to have a strong voice in how these developments shape our field through advocacy, educational endeavors and ongoing discussion. If you are not active in a Clinical TMS Society committee at this point, this is all the more reason to do so. For those that are involved, thank you for your efforts.

In closing, I want to thank Rick Pitch, Linda Carpenter, Todd Hutton and the rest of the Annual Meeting Committee. Plans are firming up for our annual meeting in Vancouver, Canada, February 21-23, 2019. As you know our meeting has continued to grow in size (attendance has quadrupled since the inception of the meeting and the society) and scientific caliber thanks to the efforts of this committee. All signs are that this will be our most widely attended meeting to date with high quality presentations. There is much to learn and discuss.

As always please stay in touch with any questions or concerns. I look forward to catching up with you in Canada in February.

Warm Regards,

Paul Croarkin, DO, MSc