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Quantitative review of the efficacy of slow-frequency magnetic brain stimulation in major depressive disorder

  • D. J. L. G. Schutter (a1)
Abstract
Background

Slow-frequency repetitive transcranial magnetic stimulation (rTMS) to the frontal cortex has been suggested as a safer and better tolerable alternative to fast-frequency rTMS in the treatment of major depressive disorder (MDD). The aim of the present study was to examine the efficacy of slow-frequency rTMS to the frontal cortex in MDD.

Method

A literature search was carried out in the databases PubMed and Web of Science in the period between January 1994 and July 2009 with the search terms ‘depression’ and ‘transcranial magnetic stimulation’. Nine double-blind sham-controlled parallel intention-to-treat studies (252 patients) fulfilled inclusion criteria and were entered in a random-effects meta-analysis.

Results

The test for heterogeneity was not significant (QT=9.63, p=0.38). An overall weighted moderate mean effect size (d=0.63, 95% confidence interval=0.03–1.24) for active treatment was observed.

Conclusions

The findings suggest that slow-frequency rTMS to the frontal cortex is more effective than sham treatment and may be equally effective as fast-frequency rTMS in the treatment of MDD.

Copyright
Corresponding author
*Address for correspondence: D. J. L. G. Schutter, Ph.D., Experimental Psychology, Utrecht University, Heidelberglaan 2, 3584CSUtrecht, The Netherlands. (Email: d.schutter@uu.nl)
Linked references
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

DJLG Schutter , J van Honk (2010). An endocrine perspective on the role of steroid hormones in the antidepressant treatment efficacy of transcranial magnetic stimulation. Psychoneuroendocrinology 35, 171178.

HR Siebner , N Lang , V Rizzo , MA Nitsche , W Paulus , RN Lemon , JC Rothwell (2004). Preconditioning of low-frequency repetitive transcranial magnetic stimulation with transcranial direct current stimulation: evidence for homeostatic plasticity in the human motor cortex. Journal of Neuroscience 24, 33793385.

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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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