Repetitive transcranial magnetic stimulation (rTMS) at high and low frequency: an efficacious therapy for major drug-resistant depression?

摘要: Abstract Objective Repetitive transcranial magnetic stimulation (rTMS) is proposed for the treatment of drug-resistant depression. Studies performed in accordance with evidence-based medicine (EBM) are scarce, particularly seeking optimal and evaluation parameters. We aimed to test various types rTMS a large sample depressed patients following EBM rules investigate treatment-related changes plasma levels neurotransmitters involved Methods Seventy-one were randomly assigned low (1 Hz) or high (17 Hz) rate TMS, applied 5 days over left dorsolateral prefrontal cortex (L-DLPFC). Patients separated into two study designs. One group (20 patients) received only active treatment, while other entered double-blind, placebo-controlled, crossover design. Pre- post-treatment blood samples taken dopamine serotonin. Results After week had measurable benefit. However, overall placebo did not differ significantly from real stimulation, nor differences observed between rates rTMS. The difference emerged when was at 17 Hz treatment. Plasma similar. Conclusions Using schedule 1 week, although clinical improvement after indeed observed, this both clinically biochemically indistinguishable that seen arm. Significance This suggests most previous emphasis, short period should be tempered down further work required order verify whether parameters TMS-treatment depression beyond effect may found rules.