Repetitive Transcranial Magnetic Stimulation in the Treatment of Depressive Disorder –  a Randomized, Single‑blind, Antidepressants‑ controlled Study


Authors: L. Ustohal;  H. Přikrylová Kučerová;  R. Přikryl;  I. Stehnová;  V. Hublová;  M. Mayerová;  S. Venclíková;  E. Češková;  T. Kašpárek
Authors‘ workplace: CEITEC – Středoevropský technologický institut MU, Brno ;  Psychiatrická klinika LF MU a FN Brno
Published in: Cesk Slov Neurol N 2014; 77/110(5): 602-607
Category: Original Paper

Tato práce vznikla díky projektu „CEITEC – Středoevropského technologického institutu“ (CZ.1.05/1.1.00/02.0068) z Evropského regionálního rozvojového fondu, výzkumnému projektu MŠMT ČR (číslo projektu 0021622404) a projektu (Ministerstva zdravotnictví) koncep­čního rozvoje výzkumné organizace 65269705 (FN Brno).

Overview

Aim:
The aim of our randomized, single‑blind study was to assess the efficacy of high‑frequency repetitive transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in comparison with common antidepressants of the third or fourth generation in patients with depressive disorder.

Methods:
Forty patients dia­gnosed with a depressive episode or recurrent depressive disorder were included in the study. They were randomised into two groups. One group was treated after one‑week wash‑ out period with stimulation, the other with antidepressants. Every patient was rated before and after the treatment using Hamilton depression rating scale (HAMD) and Montgomery Äsberg depression rating scale (MADRS). The stimulation was administered over the left dorsolateral prefrontal cortex, the stimulation frequency was 15 Hz, the intensity was 110% of resting motor threshold, the whole number of pulses during one session was 1,500 and the number of sessions was 15. Patients in a control group were treated with antidepressants.

Results:
In the stimulation group, the psychopathology score decreased statistically significantly (p = 0.001) on both scales (HAMD: from 21.15 ± 3.63 to 9.05 ± 3.76; MADRS: from 28.95 ± 4.25 to 13.00 ± 4.89). The psychopathology score in the control group of patients treated with antidepressants also decreased statistically significantly (p = 0.001) on both scales (HAMD: from 21.05 ± 2.79 to 9.55 ± 3.24; MADRS from 29.70 ± 3.92 to 13.55 ± 3.93). The difference between both groups was not statistically significant. There were 14 responders in the stimulation group and 13 responders in the control group.

Conclusion:
Our study confirmed that repetitive transcranial magnetic stimulation was effective in the treatment of depressive disorder and this effect was not inferior to the effect of common antidepressants.

Key words:
repetitive transcranial magnetic stimulation – depressive disorder – treatment – psychopathology

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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