Task-Modulated Brain Activity Predicts Antidepressant Responses of Prefrontal Repetitive Transcranial Magnetic Stimulation: A Randomized Sham-Control Study

Background Prolonged intermittent theta-burst stimulation (piTBS) and repetitive transcranial magnetic stimulation (rTMS) are effective antidepressant interventions for major depressive disorder (MDD). Cognition-modulated frontal theta (frontalθ) activity had been identified to predict the antidepressant response to 10-Hz left prefrontal rTMS. However, whether this marker also predicts that of piTBS needs further investigation. Methods The present double-blind randomized trial recruited 105 patients with MDD who showed no response to at least one adequate antidepressant treatment in the current episode. The recruited patients were randomly assigned to one of three groups: group A received piTBS monotherapy; group B received rTMS monotherapy; and group C received sham stimulation. Before a 2-week acute treatment period, electroencephalopgraphy (EEG) and cognition-modulated frontal theta changes (Δfrontalθ) were measured. Depression scores were evaluated at baseline, 1 week, and 2 weeks after the initiation of treatment. Results The Δfrontalθ at baseline was significantly correlated with depression score changes at week 1 (r = −0.383, p = 0.025) and at week 2 for rTMS group (r = −0.419, p = 0.014), but not for the piTBS and sham groups. The area under the receiver operating characteristic curve for Δfrontalθ was 0.800 for the rTMS group (p = 0.003) and was 0.549 for the piTBS group (p = 0.619). Conclusion The predictive value of higher baseline Δfrontalθ for antidepressant efficacy for rTMS not only replicates previous results but also implies that the antidepressant responses to rTMS could be predicted reliably at baseline and both piTBS and rTMS could be effective through different neurobiological mechanisms.

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Repetitive transcranial magnetic stimulation does not potentiate antidepressant treatment

European Psychiatry ◽

10.1016/j.eurpsy.2004.06.021 ◽

2004 ◽

Vol 19 (6) ◽

pp. 382-383 ◽

Cited By ~ 27

Author(s):

E. Poulet ◽

J. Brunelin ◽

C. Boeuve ◽

J. Lerond ◽

T. D’Amato ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Major Depression ◽

Magnetic Stimulation ◽

Antidepressant Treatment ◽

Repetitive Transcranial Magnetic Stimulation ◽

Controlled Study ◽

Antidepressant Effect ◽

Double Blind ◽

Pharmacological Medication

AbstractIn a double blind controlled study, rTMS results in a similar antidepressant effect to sham in combination with paroxetine. Both groups had the same delay in scale’s scores improvement. rTMS seems not to be efficient as an add-on treatment to pharmacological medication in non-resistant major depression.

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The evidence is in: Repetitive transcranial magnetic stimulation is an effective, safe and well-tolerated treatment for patients with major depressive disorder

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211043047 ◽

2021 ◽

pp. 000486742110430

Author(s):

Paul B Fitzgerald ◽

Mark S George ◽

Saxby Pridmore

Keyword(s):

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Clinical Care ◽

Case Series ◽

Evidence Base ◽

Large Network ◽

Double Blind ◽

Magnetic Stimulation Therapy ◽

Antidepressant Efficacy

Despite more than 25 years of research establishing the antidepressant efficacy of repetitive transcranial magnetic stimulation, there remains uncertainty about the depth and breadth of this evidence base, resulting in confusion as to where repetitive transcranial magnetic stimulation fits in the therapeutic armamentarium in the management of patients with mood disorders. The purpose of this article is to provide a concise description of the evidence base supporting the use of repetitive transcranial magnetic stimulation in the context of the stages of research that typically accompanies the development of evidence for a new therapy. The antidepressant efficacy for the use of repetitive transcranial magnetic stimulation in the treatment of depression has been established through a relatively traditional pathway beginning with small case series, progressing to single-site clinical trials and then to larger multisite randomised double-blind controlled trials. Antidepressant effects have been confirmed in numerous meta-analyses followed more recently by large network meta-analysis and umbrella reviews, with evidence that repetitive transcranial magnetic stimulation may have greater efficacy than alternatives for patients with treatment-resistant depression. Finally, repetitive transcranial magnetic stimulation has been shown to produce meaningful response and remission rates in real-world samples of greater than 5000 patients. The evidence for the antidepressant efficacy of repetitive transcranial magnetic stimulation therapy is overwhelming, and it should be considered a routine part of clinical care wherever available.

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Faculty Opinions recommendation of Effect of high- and low-frequency repetitive transcranial magnetic stimulation on visuospatial neglect in patients with acute stroke: a double-blind, sham-controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717976316.793474418 ◽

2013 ◽

Author(s):

Shyam Prabhakaran ◽

Shawna Cutting

Keyword(s):

Transcranial Magnetic Stimulation ◽

Acute Stroke ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Controlled Trial ◽

Low Frequency ◽

Double Blind ◽

Visuospatial Neglect

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Faculty Opinions recommendation of A detailed analysis of the effect of repetitive transcranial magnetic stimulation on negative symptoms of schizophrenia: a double-blind trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718028173.793480013 ◽

2013 ◽

Author(s):

Steven Potkin ◽

Adrian Preda

Keyword(s):

Transcranial Magnetic Stimulation ◽

Detailed Analysis ◽

Magnetic Stimulation ◽

Negative Symptoms ◽

Repetitive Transcranial Magnetic Stimulation ◽

Double Blind Trial ◽

Double Blind ◽

Blind Trial

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Impact of Repetitive Transcranial Magnetic Stimulation (rTMS) on Theory of Mind and Executive Function in Major Depressive Disorder and Its Correlation with Brain-Derived Neurotrophic Factor (BDNF): A Randomized, Double-Blind, Sham-Controlled Trial

Brain Sciences ◽

10.3390/brainsci11060765 ◽

2021 ◽

Vol 11 (6) ◽

pp. 765

Author(s):

Jie Tong ◽

Jie Zhang ◽

Ying Jin ◽

Weiqing Liu ◽

Hao Wang ◽

...

Keyword(s):

Major Depressive Disorder ◽

Executive Function ◽

Transcranial Magnetic Stimulation ◽

Theory Of Mind ◽

Depressive Disorder ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Major Depressive ◽

Double Blind ◽

Perseverative Errors

Background: Studies have implicated hypofrontality in the pathogenesis of impaired theory of mind (ToM) and executive function (EF) in major depressive disorder (MDD). These symptoms are usually resistant to treatment. Repetitive transcranial magnetic stimulation (rTMS) has been shown to reverse hypofrontality. Moreover, BDNF is an effective biomarker of antidepressant effects, but there have been very few studies on the correlation between BDNF and rTMS. We aimed to evaluate the efficacy of 20 sessions of a 10 Hz unilateral rTMS intervention over the left dorsolateral prefrontal cortex (DLPFC) in improving ToM and EF in patients with MDD and its correlation with BDNF. Methods: A total of 120 MDD patients were enrolled in this randomized, sham-controlled, double-blind trial. Each participant received 20 sessions of rTMS at 10 Hz frequency through the active or the sham coil over 4 weeks. ToM was assessed with the facial emotion identification test (FEIT) and hinting task (HT). EF was assessed with the Wisconsin card sorting test (WCST). BDNF assessments were carried out at baseline and 2-, 4-, 12-, and 24-week follow-ups. Results: The improvement in the ToM (FEIT, HT) in the active rTMS group was significantly different from that in the sham rTMS group (F = 18.09, p < 0.001; F = 5.02, p = 0.026). There were significant differences in the WCST (categories completed, response errors, response perseverative errors, non-response perseverative errors) after logarithmic transformation at different time points in the active rTMS group (F = 14.71, p < 0.001; F = 5.99, p = 0.046; F = 8.90, p = 0.031; F = 2.31, p = 0.048). However, there was no significant difference in log transformed BDNF concentration between the two groups (t = 0.07 to t = 1.29, p > 0.05). BDNF was negatively correlated with WCST categories completed at the 24th week (r = −0.258, p = 0.046). Conclusions: The results show that rTMS may improve the ToM and EF of patients with MDD and there was no significant correlation with serum BDNF concentration. RTMS can not only be used for treatment of patients with MDD but also has a positive effect on ToM and EF.

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