Pilot Study of Accelerated Low-Frequency Right-Sided Transcranial Magnetic Stimulation for Treatment-Resistant Depression

The Journal of ECT
Phern-Chern TorColleen K Loo

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is an effective option for treatment-resistant depression but requires prolonged repeated daily treatments for 4 to 6 weeks. Pilot studies have showed the possibility of accelerating rTMS safely and efficaciously but thus far only investigated high-frequency left-sided rTMS. We sought to investigate the safety and efficacy of accelerated low-frequency right-sided rTMS. Our study was an open label accelerated rTMS pilot in 7 treatment-resistant patients (4 unipolar, 3 BP). Accelerated rTMS was given over the right dorsolateral prefrontal cortex at 120% of resting motor threshold at 1 Hz, and 900 pulses were delivered per session. A single rTMS treatment was administered on the first day to test for tolerability, followed by 5 rTMS sessions a day for 2 days, then 7 days of daily rTMS sessions. The total course consisted of 16,200 pulses across 18 sessions given over 10 consecutive weekdays. The primary outcomes of interest were self- and clinician-rated depression scores (BDI-II and MADRS). All patients successfully and safely completed the accelerated rTMS treatment. MADRS scores decreased significantly by the third day of treatment and BDI II scores by the end of the 10-day tr...Continue Reading

References

Apr 1, 1979·The British Journal of Psychiatry : the Journal of Mental Science·S A Montgomery, M Asberg
Feb 24, 2004·Brain Topography·Uwe HerwigCarlos Schönfeldt-Lecuona
Apr 9, 2005·Journal of the American Geriatrics Society·Ziad S NasreddineHoward Chertkow
Aug 8, 2006·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Paul B FitzgeraldZafiris J Daskalakis
Sep 21, 2007·The International Journal of Neuropsychopharmacology·Colleen K LooPhilip B Mitchell
Feb 5, 2009·The Journal of Clinical Psychiatry·Abebaw FekaduAnthony J Cleare
Aug 25, 2010·Depression and Anxiety·Paul E HoltzheimerCharles M Epstein

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