A randomized trial of rTMS targeted with MRI based neuro-navigation in treatment-resistant depression

Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology
Paul B FitzgeraldZafiris J Daskalakis

Abstract

The aim of this study is to investigate whether repetitive transcranial magnetic stimulation (rTMS) targeted to a specific site in the dorsolateral prefrontal cortex (DLPFC), with a neuro-navigational method based on structural MRI, would be more effective than rTMS applied using the standard localization technique. Fifty-one patients with treatment-resistant depression were randomized to receive a 3-week course (with a potential 1-week extension) of high-frequency (10 Hz) left-sided rTMS. Thirty trains (5 s duration) were applied daily 5 days per week at 100% of the resting motor threshold. Treatment was targeted with either the standard 5 cm technique (n=27) or using a neuro-navigational approach (n=24). This involved localizing the scalp location that corresponds to a specific site at the junction of Brodmann areas 46 and 9 in the DLPFC based on each individual subject's MRI scan. There was an overall significant reduction in the Montgomery-Asberg Depression Rating Scale scores over the course of the trial, and a better outcome in the targeted group compared with the standard localization group at 4 weeks (p=0.02). Significant differences were also found on secondary outcome variables. The use of neuro-navigational methods t...Continue Reading

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Citations

Jul 31, 2012·Der Nervenarzt·C Plewnia, F Padberg
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Aug 21, 2009·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Mark S George, Gary Aston-Jones
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