OBJECTIVES:High frequency left-sided (HFL) and low frequency right-sided (LFR) unilateral repetitive transcranial magnetic stimulation (rTMS) are efficacious in treatment-resistant major depression (TRD). Similar benefit has been suggested for sequential bilateral rTMS (LFR then HFL). There are few published reports on the efficacy of sequential bilateral rTMS compared to HFL and sham rTMS. Therefore, this study evaluated the efficacy of HFL and sequential bilateral rTMS compared to sham in TRD. METHODS:Subjects between the ages of 18 and 85 were recruited from a tertiary care university hospital. Seventy-four subjects with TRD and a 17-item Hamilton Depression Rating Scale (HDRS) greater than 21 were randomized to receiveunilateral, bilateral, or sham rTMS. The rates of remission were compared among the three treatment groups. RESULTS: The remission rates differed significantly among the three treatment groups using a modified intention to treat analysis that excluded subjects who did not respond to electroconvulsive therapy (ECT) during the current episode. The remission rate was significantly higher in the bilateral group than the sham group. The remission rate in the unilateral group did not differ from either group. CONCLUSION: These findings warrant larger controlled studies that compare the efficacy of sequential bilateral rTMS and HFL rTMS in TRD.
RCT Entities:
OBJECTIVES: High frequency left-sided (HFL) and low frequency right-sided (LFR) unilateral repetitive transcranial magnetic stimulation (rTMS) are efficacious in treatment-resistant major depression (TRD). Similar benefit has been suggested for sequential bilateral rTMS (LFR then HFL). There are few published reports on the efficacy of sequential bilateral rTMS compared to HFL and sham rTMS. Therefore, this study evaluated the efficacy of HFL and sequential bilateral rTMS compared to sham in TRD. METHODS: Subjects between the ages of 18 and 85 were recruited from a tertiary care university hospital. Seventy-four subjects with TRD and a 17-item Hamilton Depression Rating Scale (HDRS) greater than 21 were randomized to receive unilateral, bilateral, or sham rTMS. The rates of remission were compared among the three treatment groups. RESULTS: The remission rates differed significantly among the three treatment groups using a modified intention to treat analysis that excluded subjects who did not respond to electroconvulsive therapy (ECT) during the current episode. The remission rate was significantly higher in the bilateral group than the sham group. The remission rate in the unilateral group did not differ from either group. CONCLUSION: These findings warrant larger controlled studies that compare the efficacy of sequential bilateral rTMS and HFL rTMS in TRD.
Authors: Laura E Leggett; Lesley J J Soril; Stephanie Coward; Diane L Lorenzetti; Gail MacKean; Fiona M Clement Journal: Prim Care Companion CNS Disord Date: 2015-11-05
Authors: Simon Newstead; Hayley Young; David Benton; Gabriela Jiga-Boy; Maria L Andrade Sienz; R M Clement; Frédéric Boy Journal: Exp Brain Res Date: 2017-11-02 Impact factor: 1.972
Authors: Alisson Paulino Trevizol; Kyle W Goldberger; Benoit H Mulsant; Tarek K Rajji; Jonathan Downar; Zafiris J Daskalakis; Daniel M Blumberger Journal: Int J Geriatr Psychiatry Date: 2019-04-08 Impact factor: 3.485
Authors: Benoit H Mulsant; Daniel M Blumberger; Zahinoor Ismail; Kiran Rabheru; Mark J Rapoport Journal: Clin Geriatr Med Date: 2014-06-14 Impact factor: 3.076
Authors: Daniel M Blumberger; Jerome J Maller; Lauren Thomson; Benoit H Mulsant; Tarek K Rajji; Missy Maher; Patrick E Brown; Jonathan Downar; Fidel Vila-Rodriguez; Paul B Fitzgerald; Zafiris J Daskalakis Journal: J Psychiatry Neurosci Date: 2016-06 Impact factor: 6.186