Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-23T10:02:38.341Z Has data issue: false hasContentIssue false
  • English
  • Français

Augmentative Repetitive Transcranial Magnetic Stimulation (rTMS) in the Acute Treatment of Poor Responder Depressed Patients: A Comparison Study Between High and Low Frequency Stimulation

Published online by Cambridge University Press:  15 April 2020

B. Dell’Osso ,
L. Oldani ,
G. Camuri ,
C. Dobrea ,
L. Cremaschi ,
B. Benatti ,
C. Arici ,
B. Grancini  and
A. Carlo Altamura
B. Dell’Osso*
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy Bipolar Disorders Clinic, Stanford Medical School, Stanford University, CA, USA
L. Oldani
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
G. Camuri
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
C. Dobrea
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
L. Cremaschi
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
B. Benatti
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
C. Arici
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
B. Grancini
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
A. Carlo Altamura
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
*
⁎Corresponding author. Tel.: +02 55 03 5994; Fax: +02 50 32 0310. E-mail address:bernardo.dellosso@unimi.it (B. Dell'Osso).
Get access

Abstract

Background:

While the efficacy of repetitive transcranial magnetic stimulation (rTMS) in Major Depressive Disorder (MDD) is well established, the debate is still open in relation to bipolar depression and to a possible different effectiveness of high vs. low stimulation. The present study was aimed to assess and compare the efficacy and tolerability of different protocols of augmentative rTMS in a sample of patients with current Major Depressive Episode (MDE), poor drug response/treatment resistance and a diagnosis of MDD or bipolar disorder.

Methods:

Thirty-three patients were recruited in a 4-week, blind-rater, rTMS trial and randomised to the following three groups of stimulation: (1) (n = 10) right dorsolateral prefrontal cortex (DLPFC) 1 HZ, 110% of the motor threshold (MT), 420 stimuli/day; (2) (n = 10) right DLPFC, 1 Hz, 110% MT, 900 stimuli/day; (3) (n = 13) left DLPFC, 10 Hz, 80% MT, 750 stimuli/day.

Results:

Twenty-nine patients completed the treatment, showing a significant reduction of primary outcome measures (HAM-D, MADRS and CGI-S total scores: t = 8.1, P < 0.001; t = 8.6, P < 0.001; t = 4.6, P < 0.001 respectively). No significant differences in terms of efficacy and tolerability were found between high vs. low frequency and between unipolar and bipolar patients. Side effects were reported by 21% of the sample. One of the 4 dropouts was caused by a hypomanic switch.

Conclusions:

Augmentative rTMS appeared to be effective and well tolerated for the acute treatment of unipolar and bipolar depression with features of poor drug response/treatment resistance, showing a comparable effectiveness profile between protocols of high and low frequency stimulation.

Keywords

Repetitive transcranial magnetic stimulation (rTMS)AugmentationPoor drug responseTreatment resistanceMajor depressive disorderBipolar disorder
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 2 , February 2015 , pp. 271 - 276
Copyright
Copyright © Elsevier Masson SAS 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric, Association. Diagnostic and statistical manual of mental disorders 4th ed. Washington, DC: American Psychiatry Publishing; 2000.Google Scholar
Berlim, M.T., Neufeld, N.H., Van den Eynde, F.. Repetitive transcranial magnetic stimulation (rTMS) for obsessive-compulsive disorder (OCD): an exploratory meta-analysis of randomized and sham-controlled trials. J Psychiatr Res 2013;47 (8):999–1006.CrossRefGoogle ScholarPubMed
Berlim, M.T., Broadbent, H.J., Van den Eynde, F.. Blinding integrity in randomized sham-controlled trials of repetitive transcranial magnetic stimulation for major depression: a systematic review and meta-analysis. Int J Neuropsychopharmacol 2013;16 (5):1173–1181.CrossRefGoogle ScholarPubMed
Berlim, M.T., Van den Eynde, F., Daskalakis, Z.J.. Efficacy and acceptability of high frequency repetitive transcranial magnetic stimulation (rTMS) versus electroconvulsive therapy (ECT) for major depression: a systematic review and meta-analysis of randomized trials. Depress Anxiety 2013;30 (7):614–623.CrossRefGoogle ScholarPubMed
Berlim, M.T., Van den Eynde, F., Jeff Daskalakis, Z.. Clinically meaningful efficacy and acceptability of low-frequency repetitive transcranial magnetic stimulation (rTMS) for treating primary major depression: a meta-analysis of randomized, double-blind and sham-controlled trials. Neuropsychopharmacology 2013;38 (4):543–551.CrossRefGoogle ScholarPubMed
Chen, J., Zhou, C., Wu, B., Wang, Y., Li, Q., Wei, Y., et al.Left versus right repetitive transcranial magnetic stimulation in treating major depression: a meta-analysis of randomised controlled trials. Psychiatry Res 2013;210 :1260–1264.CrossRefGoogle ScholarPubMed
Cristancho, M.A., Helmer, A., Connolly, R., Cristancho, P., O’Reardon, J.P.. Transcranial magnetic stimulation maintenance as a substitute for maintenance electroconvulsive therapy: a case series. J ECT 2013;29 (2):106–108.CrossRefGoogle ScholarPubMed
Dell’Osso, B., Mundo, E., D’Urso, N., Pozzoli, S., Buoli, M., Ciabatti, M., et al.Augmentative repetitive navigated transcranial magnetic stimulation (rTMS) in drug-resistant bipolar depression. Bipolar Disord 2009;11 (1):76–81.CrossRefGoogle Scholar
Dell’Osso, B., Camuri, G., Castellano, F., Vecchi, V., Benedetti, M., Bortolussi, S., et al.Meta-review of metanalytic studies with repetitive transcranial magnetic stimulation (rTMS) for the treatment of major depression. Clin Pract Epidemiol Ment Health 2011;7 :167–177.CrossRefGoogle ScholarPubMed
Dell’Osso, B., D’Urso, N., Castellano, F., Ciabatti, M., Altamura, A.C.. Long-term efficacy after acute augmentative repetitive transcranial magnetic stimulation in bipolar depression: a 1-year follow-up study. J ECT 2011;27 (2):141–144.CrossRefGoogle ScholarPubMed
Dolberg, O.T., Dannon, P.N., Schreiber, S., Grunhaus, L.. Transcranial magnetic stimulation in patients with bipolar depression: a double blind, controlled study. Bipolar Disord 2002;4 (Suppl. 1):94–95.CrossRefGoogle ScholarPubMed
Eche, J., Mondino, M., Haesebaert, F., Saoud, M., Poulet, E., Brunelin, J.. Low- vs high-frequency repetitive transcranial magnetic stimulation as an add-on treatment for refractory depression. Front Psychiatry 2012;3 :13.CrossRefGoogle ScholarPubMed
First, M., Spitzer, R., Gibbon, M., Williams, J.Structured clinical interview for DSM-IV-TR axis I disorders, research version, clinician version (SCID-CV). Washington, DC: American Psychiatric Press, Inc; 1996.Google Scholar
Fitzgerald, P.B., Daskalakis, Z.J.. A practical guide to the use of repetitive transcranial magnetic stimulation in the treatment of depression. Brain Stimul 2012;5 (3):287–296.CrossRefGoogle ScholarPubMed
Fregni, F., Pascual-Leone, A.. Technology insight: noninvasive brain stimulation in neurology-perspectives on the therapeutic potential of rTMS and tDCS. Nat Clin Pract Neurol 2007;3 (7):383–393.CrossRefGoogle ScholarPubMed
Gaynes, B.N., Lloyd, S.W., Lux, L., Gartlehner, G., Hansen, R.A., Brode, S., et al.Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. J Clin Psychiatry 2014;75 :477–489.CrossRefGoogle ScholarPubMed
Gross, M., Nakamura, L., Pascual-Leone, A., Fregni, F.. Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies. Acta Psychiatr Scand 2007;116 (3):165–173.CrossRefGoogle ScholarPubMed
Guy, W.ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: U.S. Dept. of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, Psychopharmacology Research Branch, Division of Extramural Research Programs; 1976.Google Scholar
Hadley, D., Anderson, B.S., Borckardt, J.J., Arana, A., Li, X., Nahas, Z., et al.Safety, tolerability, and effectiveness of high doses of adjunctive daily left prefrontal repetitive transcranial magnetic stimulation for treatment-resistant depression in a clinical setting. J ECT 2011;27 (1):18–25.CrossRefGoogle ScholarPubMed
Hamilton, M.The assessment of anxiety states by rating. Br J Med Psychol 1959;32 (1):50–55.CrossRefGoogle ScholarPubMed
Hamilton, M.A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23 :56–62.CrossRefGoogle ScholarPubMed
Hedges, D.W., Higginbotham, B.J., Salyer, D.L., Lund, T.D.Transcranial magnetic stimulation effects on one-trial learning and response to anxiogenic stimuli in adult male rats. J ECT 2005;21 (1):25–30.CrossRefGoogle ScholarPubMed
Herwig, U., Lampe, Y., Juengling, F.D., Wunderlich, A., Walter, H., Spitzer, M., et al.Add-on rTMS for treatment of depression: a pilot study using stereotaxic coil-navigation according to PET data. J Psychiatr Res 2003;37 (4):267–275.CrossRefGoogle ScholarPubMed
Hovington, C.L., McGirr, A., Lepage, M., Berlim, M.T.Repetitive transcranial magnetic stimulation (rTMS) for treating major depression and schizophrenia: a systematic review of recent meta-analyses. Ann Med 2013;45 (4):308–321.CrossRefGoogle ScholarPubMed
Kamble, N., Netravathi, M., Pal, P.K.Therapeutic applications of repetitive transcranial magnetic stimulation (rTMS) in movement disorders: a review. Parkinsonism Relat Disord 2014;20 (7):695–707.CrossRefGoogle ScholarPubMed
Kimiskidis, V.K.Transcranial magnetic stimulation for drug-resistant epilepsies: rationale and clinical experience. Eur Neurol 2010;63 (4):205–210.CrossRefGoogle ScholarPubMed
Loo, C.K., Mitchell, P.B.A review of the efficacy of transcranial magnetic stimulation (TMS) treatment for depression, and current and future strategies to optimize efficacy. J Affect Disord 2005;88 (3):255–267.CrossRefGoogle ScholarPubMed
Machado, S., Paes, F., Velasques, B., Teixeira, S., Piedade, R., Ribeiro, P., et al.Is rTMS an effective therapeutic strategy that can be used to treat anxiety disorders?. Neuropharmacology 2012;62 (1):125–134.CrossRefGoogle ScholarPubMed
Melkersson, M.“Special premarket 510(k) notification for NeuroStar TMS therapy system for major depressive disorder”. Food Drug Adm 2008.Google Scholar
Montagne-Larmurier, A., Etard, O., Razafimandimby, A., Morello, R., Dollfus, S.Two-day treatment of auditory hallucinations by high frequency rTMS guided by cerebral imaging: a 6 month follow-up pilot study. Schizophr Res 2009;113 (1):77–83.Google ScholarPubMed
Montgomery, S.A., Asberg, M.A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134 :382–389.CrossRefGoogle ScholarPubMed
Nahas, Z., Molloy, M.A., Hughes, P.L., Oliver, N.C., Arana, G.W., Risch, S.C., et al.Repetitive transcranial magnetic stimulation: perspectives for application in the treatment of bipolar and unipolar disorders. Bipolar Disord 1999;1 (2):73–80.CrossRefGoogle ScholarPubMed
Nahas, Z., Kozel, F.A., Li, X., Anderson, B., George, M.S.Left prefrontal transcranial magnetic stimulation (TMS) treatment of depression in bipolar affective disorder: a pilot study of acute safety and efficacy. Bipolar Disord 2003;5 (1):40–47.CrossRefGoogle ScholarPubMed
Nierenberg, A.A., DeCecco, L.M.Definitions of antidepressant treatment response, remission, nonresponse, partial response, and other relevant outcomes: a focus on treatment-resistant depression. J Clin Psychiatry 2001;62 (Suppl. 1):5–9.Google ScholarPubMed
Noda, Y., Daskalakis, Z.J., Ramos, C., Blumberger, D.M.Repetitive transcranial magnetic stimulation to maintain treatment response to electroconvulsive therapy in depression: a case series. Front Psychiatry 2013;4 :73.CrossRefGoogle ScholarPubMed
O’Reardon, J.P., Solvason, H.B., Janicak, P.G., Sampson, S., Isenberg, K.E., Nahas, Z., et al.Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry 2007;62 (11):1208–1216.CrossRefGoogle ScholarPubMed
Ozten, E., Sayar, G.H., Karamustafalioglu, O.Hypomanic shift observed during rTMS treatment of patients with unipolar depressive disorder: four case reports. Ann Gen Psychiatry 2013;12 (1):12.Google ScholarPubMed
Pacchiarotti, I., Mazzarini, L., Colom, F., Sanchez-Moreno, J., Girardi, P., Kotzalidis, G.D., et al.Treatment-resistant bipolar depression: towards a new definition. Acta Psychiatr Scand 2009;120 (6):429–440.CrossRefGoogle ScholarPubMed
Pinter, M.M., Brainin, M.Role of repetitive transcranial magnetic stimulation in stroke rehabilitation. Front Neurol Neurosci 2013;32 :112–121.CrossRefGoogle ScholarPubMed
Ridding, M.C., Rothwell, J.C.Is there a future for therapeutic use of transcranial magnetic stimulation?. Nat Rev Neurosci 2007;8 (7):559–567.CrossRefGoogle Scholar
Rossi, S., Hallett, M., Rossini, P.M., Pascual-Leone, A.Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol 2009;120 :2008–2039.CrossRefGoogle ScholarPubMed
Rossini, P.M., Barker, A.T., Berardelli, A., Caramia, M.D., Caruso, G., Cracco, R.Q., et al.Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application. Report of an IFCN committee. Electroencephalogr Clin Neurophysiol 1994;91 (2):79–92.CrossRefGoogle ScholarPubMed
Rossini, D., Lucca, A., Magri, L., Malaguti, A., Smeraldi, E., Colombo, C., et al.A symptom-specific analysis of the effect of high-frequency left or low-frequency right transcranial magnetic stimulation over the dorsolateral prefrontal cortex in major depression. Neuropsychobiology 2010;62 (2):91–97.CrossRefGoogle ScholarPubMed
Santiago-Rodríguez, E., Cárdenas-Morales, L., Harmony, T., Fernández-Bouzas, A., Porras-Kattz, E., Hernández, A.Repetitive transcranial magnetic stimulation decreases the number of seizures in patients with focal neocortical epilepsy. Seizure 2008;17 (8):677–683.CrossRefGoogle ScholarPubMed
Sheehan, D.V., Harnett-Sheehan, K., Raj, B.A.The measurement of disability. Int Clin Psychopharmacol 11 2Suppl. 31996 89–95.CrossRefGoogle ScholarPubMed
Speer, A.M., Wassermann, E.M., Benson, B.E., Herscovitch, P., Post, R.M.Antidepressant efficacy of high and low frequency rTMS at 110% of motor threshold versus sham stimulation over left prefrontal cortex. Brain Stimul 2001;7 (1):36–41.CrossRefGoogle Scholar
Tamas, R.L., Menkes, D., El-Mallakh, R.S.Stimulating research: a prospective, randomized, double-blind, sham-controlled study of slow transcranial magnetic stimulation in depressed bipolar patients. J Neuropsychiatry Clin Neurosci 2007;19 (2):198–199.CrossRefGoogle ScholarPubMed
Xia, G., Gajwani, P., Muzina, D.J., Kemp, D.E., Gao, K., Ganocy, S.J., et al.Treatment-emergent mania in unipolar and bipolar depression: focus on repetitive transcranial magnetic stimulation. Int J Neuropsychopharmacol 2008;11 (1):119–130.CrossRefGoogle ScholarPubMed
Young, R.C., Biggs, J.T., Ziegler, V.E., Meyer, D.A.A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978;133 :429–435.CrossRefGoogle ScholarPubMed
Zeeuws, D., De Rycker, K., De Raedt, R., De Beyne, M., Baeken, C., Vanderbruggen, N.Intensive high-frequency repetitive transcranial magnetic stimulation treatment in an electroconvulsive shock therapy-resistant bipolar I patient with mixed episode. Brain Stimul 2011;4 (1):46–49.CrossRefGoogle Scholar
Zhong, S., Wang, Y., Zhao, G., Xiang, Q., Ling, X., Liu, S., et al.Similarities of biochemical abnormalities between major depressive disorder and bipolar depression: a proton magnetic resonance spectroscopy study. J Affect Disord 2014;168 :380–386.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.