Improving the antidepressant efficacy of transcranial magnetic stimulation: maximizing the number of stimulations and treatment location in treatment-resistant depression

✍ Scribed by William M. McDonald; Valerie Durkalski; Edward R. Ball; Paul E. Holtzheimer; Martina Pavlicova; Sarah H. Lisanby; David Avery; Berry S. Anderson; Ziad Nahas; Paul Zarkowski; Harold A. Sackeim; Mark S. George

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 140 KB
• Volume: 28
• Category: Article
• ISSN: 1091-4269
• DOI: 10.1002/da.20885

✦ Synopsis

Objective: To assess the efficacy of increasing the number of fast left repetitive transcranial magnetic stimulations (rTMS) (10 Hz @ 120% of motor threshold (MT) over the left dorsolateral prefrontal cortex (DLPFC)) needed to achieve remission in treatment-resistant depression (TRD). And, to determine if patients who do not remit to fast left will remit using slow right rTMS (1 Hz @ 120% MT over the right DLPFC). Method: Patients were part of a multicenter sham-controlled trial investigating the efficacy of fast left rTMS. Patients who failed to meet minimal response criteria in the sham-controlled study could enroll in this open fast left rTMS study for an additional 3-6 weeks. Patients who failed to remit to fast left could switch to slow right rTMS for up to 4 additional weeks. The final outcome measure was remission, defined as a HAM-D 3 years. Dr. McDonald is presently an unpaid consultant to NeoStim. Dr. Holtzheimer reports consulting fees from St. Jude Medical Neuromodulation, AvaCat Consulting, and Tetragenex, and is an unpaid consultant to NeoStim. Drs. McDonald and Holtzheimer are faculty at Emory University which holds a patent on TMS technology. Neither received royalties or is involved in the development or promotion of this patent. Dr.