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Published online by Cambridge University Press: 13 August 2021
Use of combined antidepressive treatment included high-frequency rhythmic transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) is one of the ways for overcoming of pharmaco-resistance in depressive patients.
The aim of the study was the search for possible EEG predictors of antidepressive effects of rTMS of the left DLPFC in combined treatment of depression.
30 female in-patients (F31.3, F33.0, F33.1, by ICD-10; 20-50 years, mean age 36.9±10.3) with pharmaco-resistant depression were enrolled in the study. Treatment included antidepressants (mainly SSRI) and a 3-week course of rTMS (20 Hz) of the left DLPFC. Correlations between pre-treatment EEG spectral power values, and post-treatment quantitative clinical assessments of patients were analyzed. Responders/non-responders were determined by standard criteria of 50% decrease in HDRS-17 scale total scores after treatment course.
Responders (23 out of 30) revealed significant (p<0.05) negative correlations between post-treatment HDRS-17 scores and pre-treatment EEG spectral power in theta-2 (6-8 Hz) and alpha-1 (8-9 Hz) frequency sub-bands in the parietal-occipital-posterior temporal leads. Non-responders (7 out of 30) showed negative correlations between the post-treatment HDRS-17 scores and pre-treatment theta-2 EEG spectral power in the frontal-central-temporal regions of the right hemisphere.
Even brief course of rTMS of the left DLPFC enhances the action of antidepressants, and allows overcoming partially the pharmaco-resistance in depressive patients. Baseline values of theta-2 and alpha-1 EEG spectral power may serve as possible predictors of the effects of combined antidepressive therapy including rTMS. The study supported by RBRF grant No.18-01-00029a.
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