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Present and future of rTMS for Treatment Resistant Depression
Location: Alte Kornkammer - 1/17/26, 11:00 AM - 1/17/26, 11:20 AM (Europe/Berlin) (20 minutes)
Present and future of rTMS for Treatment Resistant Depression
Jaime Adan, MD, PhD
CSO and Co-founder at Connectoma Neurotech; Consultant Psychiatrist at Veram Clinic, Madrid (Spain)
Jaime Adan, MD, PhD
CSO and Co-founder at Connectoma Neurotech; Consultant Psychiatrist at Veram Clinic, Madrid (Spain)
Dr. Jaime Adán Manes is a consultant psychiatrist based in Madrid, where he serves as Director of Veram Clinic, a multidisciplinary mental-health center focused on innovative, evidence-based treatments for different mental illnesses. His clinical and academic work integrates neuroscience, neurotechnology and psychotherapy, with a particular interest in the philosophy of psychiatry and the mechanisms that shape human experience.

Dr. Adán Manes has extensive expertise in repetitive transcranial magnetic stimulation (rTMS), including neuronavigated protocols and emerging accelerated interventions. He has collaborated in the development of advanced TMS approaches aimed at optimizing stimulation targets such as the DLPFC–sgACC anticorrelation point, and has led clinical implementations of high-intensity and theta-burst protocols for treatment-resistant depression. His work bridges clinical practice with technological innovation, contributing to the design and evaluation of software-guided TMS workflows.

Alongside his clinical leadership, he is engaged in ongoing research and multidisciplinary projects in neuropsychiatry, neuroimaging, and mental-health innovation. He frequently participates in academic forums to discuss the future of psychiatric care, translational neuroscience, and the integration of AI-driven tools in mental-health services.

Dr. Adán Manes is committed to expanding access to cutting-edge neuromodulation treatments and advancing a neuroscience-grounded model of modern psychiatry.

Major depression is a leading global health concern, affecting approximately 280–330 million people worldwide. Prevalence estimates indicate that 5–5.7% of adults experience depression at any given time, with women affected at roughly 1.5 times the rate of men. Depressive disorders are consistently ranked among the top causes of disability. Despite the availability of effective treatments, a large proportion of individuals—particularly in low- and middle-income countries—remains without access to evidence-based care, leaving over 70% untreated.

Within this landscape, treatment-resistant depression (TRD) represents a critical subset, affecting around 30% of patients with MDD. TRD is associated with elevated psychiatric and medical comorbidities, higher rates of suicide attempts, recurrent hospitalizations, and increased healthcare utilisation. Beyond clinical impairment, TRD imposes substantial emotional and economic burdens on families and caregivers, intensifying its societal impact.

Repetitive transcranial magnetic stimulation (rTMS) has emerged as a key alternative for treating TRD. Meta-analytic data show response rates of 29–46% and remission rates of 18–31%. However, challenges remain, including protocol heterogeneity, cost, and the fact that up to 40% of patients do not respond to standard TMS approaches. Current strategies to enhance effectiveness include increasing the number of sessions or pulses, exploring accelerated protocols, and shifting toward personalised TMS, particularly fMRI-guided and EEG-guided stimulation.

Recent advances such as the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) protocol have demonstrated rapid and high response rates in TRD, potentially surpassing traditional interventions. Looking ahead, the field is moving toward cost reduction and broader democratization of precision neuromodulation.