scholarly journals Meta-Review of Metanalytic Studies with Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Major Depression

2011 ◽  
Vol 7 (1) ◽  
pp. 167-177 ◽  
Author(s):  
Bernardo Dell’Osso ◽  
Giulia Camuri ◽  
Filippo Castellano ◽  
Vittoria Vecchi ◽  
Matteo Benedetti ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Major Depression ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Depressive Disorders ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Effective Parameters ◽  
Duration Of Treatment ◽  
Meta Analyses ◽  
Stimulation Technique

Background:Major Depression (MD) and treatment-resistant depression (TRD) are worldwide leading causes of disability and therapeutic strategies for these impairing and prevalent conditions include pharmacological augmentation strategies and brain stimulation techniques. In this perspective, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique with a favorable profile of tolerability which, despite being recently approved by the Food and Drug Administration (FDA) for the treatment of patients with medication-refractory unipolar depression, still raises some doubts about most effective parameters of stimulation.Methods:A literature search was performed using PubMed for the years 2001 through February 2011 in order to review meta-analytic studies assessing efficacy and safety issues for rTMS in depressive disorders. Fifteen meta-analyses were identified and critically discussed in order to provide an updated and comprehensive overview of the topic with specific emphasis on potentially optimal parameters of stimulation.Results:First meta-analyses on the efficacy of rTMS for the treatment of MD and TRD have shown mixed results. On the other hand, more recent meta-analytic studies seem to support the antidepressant efficacy of the technique to a greater extent, also in light of longer periods of stimulation (e.g. > 2 weeks).Conclusion:rTMS seems to be an effective and safe brain stimulation technique for the treatment of medication refractory depression. Nevertheless, further studies are needed to better define specific stimulation-related issues, such as duration of treatment as well as durability of effects and predictors of response.

scholarly journals Focal brain stimulation with repetitive transcranial magnetic stimulation (rTMS): implications for the neural circuitry of depression

2002 ◽  
Vol 33 (1) ◽  
pp. 7-13 ◽  
Author(s):  
SARAH H. LISANBY
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Major Depression ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Severe Depression ◽  
Medical Procedure ◽  
Variable Degree ◽  
Cognitive Side Effects

BRAIN STIMULATION IN THE TREATMENT OF MAJOR DEPRESSIONRepetitive transcranial magnetic stimulation (rTMS) is an experimental medical procedure that is currently under investigation for its potential therapeutic value in major depression and other psychiatric and neurological disorders (Wassermann & Lisanby, 2001). The idea of using brain stimulation to treat depression dates back to the origins of ECT, and includes more recently developed techniques such as deep brain stimulation and vagus nerve stimulation. The value of brain stimulation in psychiatry is still most clearly seen in the, as yet, unparalleled efficacy of ECT in treating severe depression (American Psychiatric Association, 2001). While ECT is the most effective and most rapidly acting treatment for depression, it also causes a variable degree of undesirable cognitive side effects that limit its clinical utility and prevent many patients who could benefit from receiving this often life-saving treatment (McElhiney et al. 1995; Lisanby et al. 2000b). The search for an effective somatic treatment for medication resistant depression with fewer cognitive side effects than ECT has motivated much of the work with rTMS in psychiatry.

A randomized trial comparing repetitive transcranial magnetic stimulation given 3 days/week and 5 days/week for the treatment of major depression: is efficacy related to the duration of treatment or the number of treatments?

2011 ◽  
Vol 42 (5) ◽  
pp. 981-988 ◽  
Author(s):  
C. Galletly ◽  
S. Gill ◽  
P. Clarke ◽  
C. Burton ◽  
P. B. Fitzgerald
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Treatment Group ◽  
Major Depression ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Daily Treatment ◽  
Duration Of Treatment ◽  
Resting Motor Threshold ◽  
The Right

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has been shown to be an effective treatment for depression. However, there has been little research to determine optimal parameters for treatment.MethodThis study compared two rTMS treatment regimes for the treatment of major depression. Seventy-seven participants were randomized to either spaced or daily treatment. Spaced rTMS was given 3 days/week for 6 weeks (18 treatments in total) and daily rTMS was given 5 days/week for 4 weeks (20 treatments in total). All participants were assessed at baseline and after 4 weeks of treatment. Participants in the spaced treatment group were also assessed after 6 weeks of treatment. All participants were treated at 110% of the resting motor threshold with high-frequency rTMS (10 Hz) to the left dorsolateral prefrontal cortex (DLPFC) followed by low-frequency rTMS to the right DLPFC.ResultsParticipants in the daily treatment group showed more improvement by week 4 than those in the spaced treatment group; however, both groups had similar improvement by treatment completion. There was significant improvement in both groups in ratings of depression and anxiety, with no significant differences between groups.ConclusionsOur study indicates that the efficacy of rTMS is related to the number of treatments given and that spacing the treatments neither improves nor reduces efficacy.

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