Treatment of Depression Using Sleep Electroencephalogram Modulated Repetitive Transcranial Magnetic Stimulation

2011 ◽  
Vol 26 (S2) ◽  
pp. 1142-1142
Author(s):  
M. He ◽  
Z. Gu ◽  
X. Wang ◽  
H. Shi

Background and purposeThe conventional repetitive transcranial magnetic stimulation (rTMS) has some inadequate of efficacy weak and inadequate for the treatment of depression, easy symptomatic recurrence when stop the treatment. Ours invented the device of sleep electroencephalogram-modulated rTMS (SEM-rTMS) were safe and effective by proved of the animal experiments and clinical pre-test for the treatment of depression. The purpose of this study was to examine the efficacy and safety of SEM-rTMS for the treatment of depression.MethodsAfter 7 days without psychoactive medication, 164 patients with clinically defined depression, were randomly assigned to receive SEM-rTMS (N = 57), conventional rTMS (C-rTMS (N = 55), or sham-rTMS (N = 52) for 30 minutes/time/day for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome at the 10th-day of therapy for all subjects were analyzed.ResultsTwenty two cases in the SEM-rTMS group improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (c2 = 15.89, p = 0.0004). After completion of the rTMS phase of the protocol, a (51 ± 5) % reduction of HAMD-24 scores from the baseline in the SEM-rTMS group compared with a (34 ± 4)% in the C-rTMS group ((q = 26.09, p = 0.001) and a (14 ± 3)% in Sham-rTMS group (q = 57.53,p = 0.000). The 88% total efficacy ratio in the SEM-rTMS group was significant higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (c2 = 12.01, p = 0.0025). No significant side effects were noted.ConclusionIt is efficient and safe to treat depression with repetitive transcranial magnetic stimulation. (The registration. No: ChiCTR-TRC-00000438).

2005 ◽  
Vol 186 (5) ◽  
pp. 410-416 ◽  
Author(s):  
Svenja C. Schulze-Rauschenbach ◽  
Uta Harms ◽  
Thomas E. Schlaepfer ◽  
Wolfgang Maier ◽  
Peter Falkai ◽  
...  

BackgroundStudies have compared electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) with regard to clinical efficacy in the treatment of depression, but no study has yet addressed the differential impact on cognition.AimsTo compare the neurocognitive effects of unilateral ECT and rTMS.MethodThirty patients with treatment-refractory non-psychotic major depression received an average of ten treatments with either unilateral ECT or left prefrontal rTMS and were assessed for objective and subjective cognitive impairments before and about a week after treatment.ResultsTreatment response was comparable (46% of the ECT group and 44% of the rTMS group showed a reduction of 50% or more in Hamilton Rating Scale for Depression scores). In patients treated with rTMS, cognitive performance remained constant or improved and memory complaints alleviated, whereas in the ECT group memory recall deficits emerged and memory complaints remained.ConclusionsIn contrastto unilateral ECT, rTMS has no adverse memory effects.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Beppe Micallef-Trigona

Electroconvulsive therapy (ECT) is the longest standing psychiatric treatment available and has unequivocal benefit in severe depression. However this treatment comes with a number of side effects such as memory impairment. On the other hand, Repetitive Transcranial Magnetic Stimulation (rTMS) is a relatively new form of treatment which has been shown to be efficacious in patients suffering from a number of psychopathologies, including severe depression, with few reported side effects. Due to its potential therapeutic efficacy and lack of side effects, rTMS has gained traction in the treatment of depression, with a number of authors keen to see it take over from ECT. However, it is not clear whether rTMS represents a therapeutic alternative to ECT. This meta-analysis will therefore compare the “gold standard” treatment for severe depression, with the relatively new but promising rTMS. A literature search will be performed with the intention to include all randomised clinical trials. The null hypothesis is that there is no difference in the antidepressant efficacy between the two types of treatment modalities. Statistical analysis of Hamilton Depression Rating Scale (HDRS) scores will be performed.


2003 ◽  
Vol 182 (6) ◽  
pp. 480-491 ◽  
Author(s):  
José Luis R. Martin ◽  
Manuel J. Barbanoj ◽  
Thomas E. Schlaepfer ◽  
Elinor Thompson ◽  
Víctor Pérez ◽  
...  

BackgroundRepetitive transcranial magnetic stimulation (rTMS) may be useful in the treatment of depression but results from trials have been inconclusive to date.AimsTo assess the efficacy of rTMS in treating depression.MethodWe conducted a systematic review of randomised controlled trials that compared rTMS with sham in patients with depression. We assessed the quality of design of all studies and conducted a metaanalysis of data from trials with similar rTMS delivery.ResultsWe included a total of 14 trials. The quality of the included studies was low. Pooled analysis using the Hamilton Rating Scale for Depression showed an effect in favour of rTMS compared with sham after 2 weeks of treatment (standardised mean difference=–0.35; 95% CI –0.66 to –0.04), but this was not significant at the 2-week follow-up (standardised mean difference= — 0.33; 95% CI —0.84 to 0.17).ConclusionsCurrent trials are of low quality and provide insufficient evidence to support the use of rTMS in the treatment of depression.


2018 ◽  
Vol 3 (1) ◽  
pp. 55
Author(s):  
Anang Widyanta ◽  
Edith Humris ◽  
Ratna Dewi ◽  
Ni Kadek Duti

Gangguan depresi mayor merupakan gangguan kejiwaan yang membawa dampak sangat buruk pada kehidupan penderita dan lingkungannya. Berbagai metode dikembangkan dalam memberikan penatalaksanaannya, seperti obat, psikoterapi, Electroconvulsive Therapy (ECT). Repetitive Transcranial Magnetic Stimulation saat ini dikembangkan sebagai salah satu alternative pengobatan gangguan depresi mayor. Pada penelitian ini digunakan Hamilton Rating Scale for Depression (HAM-D)


2011 ◽  
Vol 26 (S2) ◽  
pp. 1143-1143
Author(s):  
M. He ◽  
Z. Gu ◽  
X. Wang ◽  
X. Tian

ObjectiveTo investigate the effects of sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) and conventional rTMS (C-rTMS) on the activity of hypothalamic-pituitary-adrenal (HPA) axis in patients with depression.MethodsIn a double-blind, randomized controlled trial, 164 patients diagnosed with depression were randomized to treatment with SEM-rTMS (n = 57), C-rTMS (n = 55) or sham rTMS (n = 52) for 30 min every day for 10 d. Before and after treatment plasma concentrations of adrenocorticotropic hormone (ACTH) and cortisol (CORT) were measured, and the 24-item Hamilton Depression Rating Scale (HAMD-24) was used for assessment.ResultsThe HAMD-24 scores and plasma ACTH and CORT concentrations of these depressive patients before treatment were significantly different from those of the normal control group (P < 0.05). The HAMD-24 scores and plasma ACTH and CORT concentrations in the SEM-r TMS group and conventional rTMS group were decreased significantly (P < 0.05). There was a significant positive correlation between the HAMD-24 scores and plasma ACTH (n = 240, r = 0.105, P = 0.048) and CORT concentrations (n = 240, r = 0.126, P = 0.023) in the patients with depression before and after treatment.ConclusionThe antidepressant effect of rTMS, including SEM-rTMS, may be related to its decreasing HPA axis activity. (This trail was registered. No: ChiCTR-TRC-00000465).


CNS Spectrums ◽  
2020 ◽  
pp. 1-6
Author(s):  
Chiara Arici ◽  
Beatrice Benatti ◽  
Rita Cafaro ◽  
Laura Cremaschi ◽  
Luca Degoni ◽  
...  

Abstract Background Little is known about the post-acute effects of repetitive transcranial magnetic stimulation (rTMS) in patients with major depression. The present study focused on the 6-month follow-up of a sample of patients with major depression, after the completion of an acute 4 weeks rTMS trial, with the aim of evaluating response (in terms of sustained and late response) and relapse rates. Methods Following the completion of an acute trial of rTMS (T0-T4), 31 drug-resistant depressed patients (bipolar or unipolar) entered a naturalistic follow-up period of 6 months, with three timepoints (T5, T6, and T7) during which they were assessed with the Hamilton Depression Rating Scale and the Young Mania Rating Scale. Results Results showed that in the 6 months following an acute transcranial magnetic stimulation (TMS) trial, a higher rate of late responders was observed among previously acute TMS nonresponders (63.64%, 7 out of 11) compared to the rate of relapse among those who had acutely responded to TMS (10%, 2 out of 20). In addition, an overall high rate of maintained response (90%) was observed. Conclusion Present findings seem to support the possibility of obtaining a clinical response also after the end of an acute TMS trial in patients with major depression. The concomitant low rate of relapse observed at the end of follow-up along with a high rate of maintained response provides further support to the post-acute efficacy of TMS. Nonetheless, further controlled studies, with larger samples and longer follow-up observation, are needed to confirm the reported results.


2013 ◽  
Vol 16 (9) ◽  
pp. 1975-1984 ◽  
Author(s):  
Paul B. Fitzgerald ◽  
Kate E. Hoy ◽  
Ajeet Singh ◽  
Ranil Gunewardene ◽  
Christopher Slack ◽  
...  

Abstract Repetitive transcranial magnetic stimulation treatment (rTMS) is an effective treatment for depression but the optimal methods of administration have yet to be determined. Recent studies have produced conflicting results as to whether unilateral rTMS is more or less effective than sequentially applied bilateral rTMS. To address this we conducted a trial comparing sequential bilateral rTMS to right-sided unilateral rTMS using a priming protocol. Patients with treatment-resistant depression (n = 179) were enrolled in a two-arm randomized controlled trial across a 4-wk time period. The primary outcome assessment was the Hamilton Depression Rating Scale. Overall, there was a substantial response rate of >50% (and a 40% remission rate); however, there were no significant differences in clinical response between the two treatment groups. rTMS was well tolerated with a very low discontinuation rate. There was no relationship between response in the current trial and previous response, or non-response, to electroconvulsive therapy. We found no significant differences in clinical response between sequential bilateral rTMS and right-sided unilateral rTMS applied with a priming protocol. The results of this study do not support superior efficacy of bilateral rTMS and instead suggest that other approaches should be explored to increase treatment efficacy.


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