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07-02 TMS treatment for depression: overview of efficacy and report on a sham-controlled trial of twice daily left prefrontal rTMS

Published online by Cambridge University Press:  24 June 2014

P Mitchell ,
C Loo ,
G Malhi ,
T McFarquhar  and
P Sachdev
P Mitchell
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Black Dog Institute, Prince of Wales Hospital, Sydney, New South Wales, Australia
C Loo
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Black Dog Institute, Prince of Wales Hospital, Sydney, New South Wales, Australia
G Malhi
Affiliation:
Black Dog Institute, Prince of Wales Hospital, Sydney, New South Wales, Australia Academic Discipline of Psychological Medicine, Northern Clinical School, University of Sydney, Sydney, Australia
T McFarquhar
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Black Dog Institute, Prince of Wales Hospital, Sydney, New South Wales, Australia
P Sachdev
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, New South Wales, Australia
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Abstract

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Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006 , pp. 330
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

The majority of clinical trials have reported positive statistical results for repetitive transcranial magnetic stimulation (rTMS) (compared with a sham control) in treating depression, but the results of many studies were not clinically impressive. Recent studies have explored strategies to optimize the efficacy of rTMS. One such strategy is to increase the frequency of treatment sessions. The efficacy of twice-daily sessions of rTMS has not been previously examined in sham-controlled trials.

Methods:

Thirty-eight subjects with DSM-IV major depressive episode were randomly assigned to receive active or sham rTMS for 2 weeks, with two treatment sessions per weekday. Treatment was given to the left prefrontal cortex at 10 Hz, 30 trains of 5 s, 110% motor threshold. Subjects were allowed to receive up to 6 weeks of active daily rTMS in an open extension. Mood and cognitive functioning were assessed weekly during the study.

Results:

The active treatment group improved more than the sham treatment group over the 2-week sham-controlled period on Montgomery-Asberg Depression Rating Scale (MADRS) (P < 0.05) but not Hamilton Depression Rating scales. After 6 weeks of active treatment, 53% and 47% of subjects achieved response (>50% improvement) and remission (MADRS <10), respectively. rTMS was well tolerated.

Conclusion:

High-frequency left prefrontal rTMS given twice a day was safe and more effective than sham in treating depression.