TMS 1993-2004
a. Decrease in depression ratings (percent decrease based on HAMD or MADRS scores)
b. Response rate (defined as a ≥50% decrease in HAMD or MADRS score)
c. Remission rate (defined as endpoint HAMD ≤ 8).
Their references and comments are cited below:
1. Hoflich G, Kasper S, Hufnagel A, S R, HJ M (1993): Application of transcranial magnetic stimulation in treatment of drug-resistant major depression— A report of two cases. Human Psychopharmacology 8:361-365.
No therapeutic effect.
2. George MS, Wassermann EM, Williams WA, et al (1995): Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. Neuroreport 6:1853-6.
Mean HAMD decreased from 23.8 to 17.5. Two robust responders, two mild responders, two non-responders (who were also ECT non-responders).
3. Grisaru N, Yarovslavsky U, Abarbanel J, Lamberg T, Belmaker RH (1994): Transcranial magnetic stimulation in depression and schizophrenia. European Neuropsychopharmacology 4:287-288 (abstract).
4 patients had slight improvement, 1 worsened, 5 showed no change.
4. Kolbinger H, Hoflich G, Hufnagel A, et al. (1995): Transcranial magnetic stimulation (TMS) in the treatment of major depression - a pilot study. Human Psychopharmacology 10:305-310.
Both rTMS groups improved slightly.
5. Conca A, Koppi S, Konig P, Swoboda E, Krecke N (1996): Transcranial magnetic stimulation: a novel antidepressive strategy? Neuropsychobiology 34:204-7.
rTMS used as an add-on to medication.
6. Pascual-Leone A, Rubio B, Pallardo F, Catala MD (1996): Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. Lancet 348:233-7.
HAMD decreased from 25.2 to 13.8 after 5 sessions. Study included multiple control conditions, including vertex stimulation, right DLPFC stimulation, and sham rTMS.
7. George MS, Wassermann EM, Kimbrell TA, et al (1997): Mood improvement following daily left prefrontal repetitive transcranial magnetic stimulation in patients with depression: a placebo-controlled crossover trial. Am J Psychiatry 154:1752-6.
rTMS superior to Sham, but small decrease in depression rating.
8. Geller V, Grisaru N, Abarbanel JM, Lemberg T, Belmaker RH (1997): Slow magnetic stimulation of prefrontal cortex in depression and schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 21:105-10.
6 MDD/3 BMD/1 schizoaffective depressed included. Different group from previous open trial. Improvement is based of HAM-D results 2 hrs after treatment. Seven days after treatment showed 15% decrease. 28 days after showed 34% decrease in 9/10 patients.
9. Figiel GS, Epstein C, McDonald WM, et al (1998): The use of rapid-rate transcranial magnetic stimulation (rTMS) in refractory depressed patients. J Neuropsychiatry Clin Neurosci 10:20-5.
Sample overlaps with Epstein study, but includes new sample >65. Results calculated on 50 pts who completed study. Only 23% of >65 responded; 56% of those <65 responded. No seizures, but in two subjects, muscular contractions spread from a single hand muscle to more proximal muscles of the right upper extremity.
10. Feinsod M, Kreinin B, Chistyakov A, Klein E (1998): Preliminary evidence for a beneficial effect of low-frequency, repetitive transcranial magnetic stimulation in patients with major depression and schizophrenia. Depress Anxiety 7:65-8.
11. Avery DH, Claypoole K, Robinson L, et al (1999): Repetitive transcranial magnetic stimulation in the treatment of medication-resistant depression: preliminary data. J Nerv Ment Dis 187:114-7.
Slight improvement in rTMS group compared with sham. No decrement in neuropsychological tests with rTMS.
12. Klein E, Kreinin I, Chistyakov A, et al (1999): Therapeutic efficacy of right prefrontal slow repetitive transcranial magnetic stimulation in major depression: a double-blind controlled study. Arch Gen Psychiatry 56:315-20.
HAM-D decreased from 25.8 to 13.7 with rTMS and 25.3 to 19.7 with sham. Three dropouts (1 rTMS, 2 sham). Of rTMS patients, 49% were responders (w/ >50% decrease in HAM-D); of sham patients, 25% were responders.
13. Loo C, Mitchell P, Sachdev P, McDarmont B, Parker G, Gandevia S (1999): Double-blind controlled investigation of transcranial magnetic stimulation for the treatment of resistant major depression. Am J Psychiatry 156:946-8.
With rTMS significant decreases in HAMD after 10 sessions, but not different from sham. With rTMS, 44.9% decrease from baseline at one month follow-up.
14. Pridmore S, Rybak M, Turnier-Shea Y, Reid P, Bruno R, Couper D (1999): A naturalistic study of response in melancholia to transcranial magnetic stimulation (TMS). German Journal of Psychiatry 2:13-21.
The average reduction in the Montgomery-Asberg Depression Rating (MADRS) was 38.5 to 16.8 (56% decrease). The mean time from treatment to relapse was 20 weeks.
15. Triggs WJ, McCoy KJ, Greer R, et al (1999): Effects of left frontal transcranial magnetic stimulation on depressed mood, cognition, and corticomotor threshold. Biol Psychiatry 45:1440-6.
5/10 had at least 50% reduction in HAMD. No adverse effects on neuropsychological tests. Motor evoked potential threshold decreased during treatment in 9/10.
16. Pridmore S (1999): Rapid transcranial magnetic stimulation and normalization of the dexamethasone suppression test. Psychiatry Clin Neurosci 53:33-7.
Overall, mean MADRS decreased from 35.8 to 16.8 (53% decrease). All 12 patients were dexamethasone non-suppressors at baseline. 6 of 12 normalized the DST after treatment with rTMS. These 6 had good clinical improvement (MADRS decreased from 31 to 9) and maintained their response for at least 4 weeks.
17. Kimbrell TA, Little JT, Dunn RT, et al (1999): Frequency dependence of antidepressant response to left prefrontal repetitive transcranial magnetic stimulation (rTMS) as a function of baseline cerebral glucose metabolism. Biol Psychiatry 46:1603-13.
2/13 responded (greater than 50% response) There was a negative correlation between the degree of antidepressant response after 1 Hz compared to 20 Hz. Better response to 20 hz was associated with the degree of baseline hypometabolism measured by PET, whereas 1 Hz rTMS tended to be associated with baseline hypermetabolism. 1/10 responded in 20 Hz group. 0/3 responded in sham group.
18. Stikhina N, Lyskov EB, Lomarev MP, Aleksanian ZA, Mikhailov VO, Medvedev SV (1999): [Transcranial magnetic stimulation in neurotic depression]. Zh Nevrol Psikhiatr Im S S Korsakova 99:26-9.
TMS significantly better than control condition.
19. Padberg F, Zwanzger P, Thoma H, et al (1999): Repetitive transcranial magnetic stimulation (rTMS) in pharmacotherapy-refractory major depression: comparative study of fast, slow and sham rTMS. Psychiatry Res 88:163-71.
Improvement in verbal memory scores after fast rTMS, with no change after slow rTMS, and a trend toward poorer scores after sham.
20. Menkes DL, Bodnar P, Ballesteros RA, Swenson MR (1999): Right frontal lobe slow frequency repetitive transcranial magnetic stimulation (SF r-TMS) is an effective treatment for depression: a case-control pilot study of safety and efficacy. J Neurol Neurosurg Psychiatry 67:113-5.
Included 6 healthy controls who had no change in HAM-D score (mean 0.7). Depressed patients had decr in HAM-D from 18.4 to 10.6.
21. Schouten EA, D'Alfonso AA, Nolen WA, De Haan EH, Wijkstra J, Kahn RS (1999): Mood improvement from transcranial magnetic stimulation. Am J Psychiatry 156:669; discussion 669-70.
Poor response, Hamilton score decreased from 23.8 to 18.5. Some patients started medications during the first week of TMS. HAMD data incomplete on 3/7 patients. One responders and one partial responder (25% decrease in HAMD) were taking few or no benzodiazepines; all others were taking higher doses of benzodiazepines.
22. Berman RM, Narasimhan M, Sanacora G, et al (2000): A randomized clinical trial of repetitive transcranial magnetic stimulation in the treatment of major depression. Biol Psychiatry 47:332-7.
In rTMS group, 1/10 responded (decrease in HAM-D from 48 to 7); in sham group 0/10 responded.
23. Eschweiler GW, Wegerer C, Schlotter W, et al (2000): Left prefrontal activation predicts therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) in major depression. Psychiatry Res 99:161-72.
rTMS significantly better than sham, also used near infrared spectroscopy.
24. George MS, Nahas Z, Molloy M, et al (2000): A controlled trial of daily left prefrontal cortex TMS for treating depression. Biol Psychiatry 48:962-70.
6/10 responded (greater than 50% decrease in HAMD). 3/10 responded to 20Hz. 0/10 responded to sham.
25. Grunhaus L, Dannon PN, Schreiber S, et al (2000): Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder: an open study. Biol Psychiatry 47:314-24.
Comparison with ECT. 7/16 responded to rTMS;12/18 to ECT. Among nonpsychotic depressed 5/8 responded to rTMS; 5/10 to ECT. Among psychotically depressed, only 2/8 responded to rTMS; 7/8 to ECT.
26. Pridmore S, Bruno R, Turnier-Shea Y, Reid P, Rybak M (2000): Comparison of unlimited numbers of rapid transcranial magnetic stimulation (rTMS) and ECT treatment sessions in major depressive episode. Int J Neuropsychopharmacol 3:129-134.
Gave unlimited number of rTMS sessions (mean 12.2, SD 3.4). Compared to group of 16 pts receiving unlimited ECT treatments (mean 6.2, SD 1.6). No significant difference between the groups in HDRS improvement. Pts receiving ECT had significantly greater decrease in Beck Depression Inventory scores.
27. Conca A, Swoboda E, Konig P, et al (2000): Clinical impacts of single transcranial magnetic stimulation (sTMS) as an add-on therapy in severely depressed patients under SSRI treatment. Hum Psychopharmacol 15:429-438.
Each patient was given five stimulations to each of several sites during each session; there were 10 sessions total. sTMS was given as add-on to citalopram and trazodone therapy.
28. Garcia-Toro M, Mayol A, Arnillas H, et al (2001a): Modest adjunctive benefit with transcranial magnetic stimulation in medication-resistant depression. J Affect Disord 64:271-5.
rTMS added to current antidepressant treatments. 5/17 (29%) of patients initially randomized to rTMS were responders (>50% decr in HDRS). 15 sham non-responders crossed over to receive active 90% MT rTMS; 4/14 (29%) patients that completed 4 weeks of treatment were responders. The 9 non-responders were treated with 10 additional sessions of 110% MT rTMS; 3/9 (33%) were responders.
29. Manes F, Jorge R, Morcuende M, Yamada T, Paradiso S, Robinson RG (2001): A controlled study of repetitive transcranial magnetic stimulation as a treatment of depression in the elderly. Int Psychogeriatr 13:225-31.
Studied patients >50 y/o (mean age 60.7 yrs, SD 9.8 yrs). Neuropsych testing used MMSE; no significant difference between groups pre- or post-treatment. 6 responders (3 to rTMS and 3 to sham) had significantly greater frontal lobe volume than non-responders.
30. Garcia-Toro M, Pascual-Leone A, Romera M, et al (2001b): Prefrontal repetitive transcranial magnetic stimulation as add on treatment in depression. J Neurol Neurosurg Psychiatry 71:546-8.
Studied rTMS vs. sham as add-on treatment to sertraline for a MDE. All but two patients received benzodiazepines. Differences in response at 2 weeks in HDRS and BDI, but not at 4 weeks (2 weeks after last treatment). Non-responders to sham were crossed over to receive 90% MT rTMS with identical parameters. Non-responders to active 90% MT rTMS crossed over to receive 110% MT rTMS.
31. Lisanby SH, Pascual-Leone A, Sampson SM, Boylan LS, Burt T, Sackeim HA (2001): Augmentation of sertaline antidepressant treatment with transcranial magnetic stimulation. Biol Psychiatry 49:81S.
Compared 10 Hz LDLPFC rTMS to 1 Hz RDLPFC rTMS to sham rTMS, all as add-on therapy to sertraline 50 mg. Remission in the active TMS group combined was 25% vs. 8% in the sham group (NS). Degree of medication resistance negatively correlated with response and remission.
32. Szuba MP, O'Reardon JP, Rai AS, et al (2001): Acute mood and thyroid stimulating hormone effects of transcranial magnetic stimulation in major depression. Biol Psychiatry 50:22-7.
No efficacy data presented. Patients receiving active TMS showed greater mood improvements with acute sessions of TMS than patients receiving sham. Subjects are a subset of a larger study evaluation twice daily vs. once daily rTMS.
33. Catafau AM, Perez V, Gironell A, et al (2001): SPECT mapping of cerebral activity changes induced by repetitive transcranial magnetic stimulation in depressed patients. A pilot study. Psychiatry Res 106:151-60.
rTMS was associated with increases in regional CBF in the DLPFC, but these changes were not associated with change in HAMD.
34. Janicak PG, Dowd SM, Martis B, et al (2002): Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary results of a randomized trial. Biol Psychiatry 51:659-67.
Patients received either rTMS or bitemporal ECT (4-12 treatments). There was a raw difference in mean change in HDRS between the groups (55% with rTMS, 64% with ECT), but no statistically significant difference. There was a 46% response rate with rTMS and a 56% response rate with ECT (not statistically significant).
35. Dolberg OT, Dannon PN, Schreiber S, Grunhaus L (2002): Transcranial magnetic stimulation in patients with bipolar depression: a double blind, controlled study. Bipolar Disord 4:94-5.
Preliminary report.
36. Shajahan PM, Glabus MF, Steele JD, et al (2002): Left dorso-lateral repetitive transcranial magnetic stimulation affects cortical excitability and functional connectivity, but does not impair cognition in major depression. Prog Neuropsychopharmacol Biol Psychiatry 26:945-54.
Parallel groups study of 5 Hz, 10 Hz, and 20 Hz rTMS in 15 patients (1 dropout due to incr psychosis). All groups showed decr in HAMD21. 2/4 responders (>60% decr in HAMD21) in 5 Hz group; 1/5 responders in 10 Hz group; 2/5 responders in 20 Hz group. SPECT showed incr ant cingulate activation, incr connectivity between LPFC and basal ganglia 1 hr after stimulation (no changes on right).
37. Padberg F, di Michele F, Zwanzger P, et al (2002a): Plasma concentrations of neuroactive steroids before and after repetitive transcranial magnetic stimulation (rTMS) in major depression. Neuropsychopharmacology 27:874-8.
18/37 patients responded (50% or greater decr in HAMD), 12/37 patients remitted (HAMD 9 or less). Plasma concentration of neuroactive steroids unchanged with rTMS and unrelated to response.
38. Padberg F, Zwanzger P, Keck ME, et al (2002b): Repetitive transcranial magnetic stimulation (rTMS) in major depression: relation between efficacy and stimulation intensity. Neuropsychopharmacology 27:638-45.
Compares 100% MT rTMS to 90% MT rTMS to sham. % decr for HAMD scores. Also, for MADRS scores: 4% decr with sham, 15% decr with 90% MT rTMS, 33% decr with 100% rTMS. 3/10 responders (>50% decr in HAMD) and 2/10 partial responders (>25% decr HAMD) with 100% MT rTMS, 2/10 responders and 1/10 partial responder with 90% MT rTMS, 0/10 responders and 2/10 partial responders with sham rTMS. Patients receiving rTMS had substantially fewer days in the hospital post-treatment (43 days for 100% MT rTMS, 61 days for 90% MT rTMS, 135 days for sham rTMS).
39. Boutros NN, Gueorguieva R, Hoffman RE, Oren DA, Feingold A, Berman RM (2002): Lack of a therapeutic effect of a 2-week sub-threshold transcranial magnetic stimulation course for treatment-resistant depression. Psychiatry Res 113:245-54.
No statistically significant difference between rTMS- and sham-treated patients. Authors suggest this may relate to subthreshold rTMS intensity.
40. Conca A, Di Pauli J, Beraus W, et al (2002a): Combining high and low frequencies in rTMS antidepressive treatment: preliminary results. Hum Psychopharmacol 17:353-6.
Complex design assessing relative efficacy of high frequency LDLPFC rTMS vs high and low freq LDLPFC rTMS vs high LDLPFC and low RDLPFC rTMS. No difference in response between groups. All patients were at least Thase-Rush Stage 4 tx-resistance. Two patients (left-handed women) developed psychotic sx with high freq rTMS; sx resolved after discontinuation of rTMS.
41. Rosenberg PB, Mehndiratta RB, Mehndiratta YP, Wamer A, Rosse RB, Balish M (2002): Repetitive transcranial magnetic stimulation treatment of comorbid posttraumatic stress disorder and major depression. J Neuropsychiatry Clin Neurosci 14:270-6.
Study of rTMS for PTSD comorbid with MDD. No benefit for treating symptoms of PTSD, but patients did show an antidepressant response.
42. Schiffer F, Stinchfield Z, Pascual-Leone A (2002): Prediction of clinical response to transcranial magnetic stimulation for depression by baseline lateral visual-field stimulation. Neuropsychiatry Neuropsychol Behav Neurol 15:18-27.
Subjects are part of a larger trial. Study was designed to test whether lateral visual field stimulation predicts response to rTMS.
43. Mosimann UP, Marre SC, Werlen S, et al (2002): Antidepressant effects of repetitive transcranial magnetic stimulation in the elderly: correlation between effect size and coil-cortex distance. Arch Gen Psychiatry 59:560-1.
Open study of older depressed patients (mean age 56.4±12.7 years, range 40-74 years). Coil-cortex distance index (CCDI; ratio of distance at LDLPFC to distance at motor cortex) negatively correlated with HAMD decrease.
44. Mottaghy FM, Keller CE, Gangitano M, et al (2002): Correlation of cerebral blood flow and treatment effects of repetitive transcranial magnetic stimulation in depressed patients. Psychiatry Res 115:1-14.
Subjects are part of larger trial comparing left and right 10 Hz and 1 Hz rTMS in unipolar depression.
45. Dragasevic N, Potrebic A, Damjanovic A, Stefanova E, Kostic VS (2002): Therapeutic efficacy of bilateral prefrontal slow repetitive transcranial magnetic stimulation in depressed patients with Parkinson's disease: An open study. Mov Disord 17:528-32.
Patients with depression and Parkinson’s disease received open, 0.5 Hz rTMS over both left and right DLPFCs. Patients received 200 stimuli per day for 10 days (100 stimuli per hemisphere).
46. Schule C, Zwanzger P, Baghai T, et al (2003): Effects of antidepressant pharmacotherapy after repetitive transcranial magnetic stimulation in major depression: an open follow-up study. J Psychiatr Res 37:145-53.
Responders to rTMS showed a significant worsening in mood following cessation of rTMS treatment. This was reversed by mirtazapine.
47. Fitzgerald PB, Brown TL, Marston NA, Daskalakis ZJ, De Castella A, Kulkarni J (2003): Transcranial magnetic stimulation in the treatment of depression: a double-blind, placebo-controlled trial. Arch Gen Psychiatry 60:1002-8.
Compares 10 Hz LPF stim with 1 Hz RPF stim with sham. Initial trial was with 10 sessions: 14-15% decr in MADRS in both rTMS groups (1/20 patients in LPF group with >50% decr), 1% decr in sham. 15 patients with >20% decr in MADRS by 10 sessions went on to receive a total of 20 open rTMS sessions: 40% decr in MADRS in LPF group (4/8 patients with decr >50%), 57% decr in RPF group (4/7 patients with decr >50%).
48. Hoppner J, Schulz M, Irmisch G, Mau R, Schlafke D, Richter J (2003): Antidepressant efficacy of two different rTMS procedures High frequency over left versus low frequency over right prefrontal cortex compared with sham stimulation. Eur Arch Psychiatry Clin Neurosci 253:103-9.
Patients were started on an antidepressant medication 2 weeks before rTMS, which was used as an add-on treatment.
49. Herwig U, Lampe Y, Juengling FD, et al (2003): Add-on rTMS for treatment of depression: a pilot study using stereotaxic coil-navigation according to PET data. J Psychiatr Res 37:267-75.
Left vs. right prefrontal location of stimulation guided by PET-identified prefrontal hypometabolism (when present). 11 of 25 patients had right prefrontal hypometabolism at baseline. 1 of 25 had left prefrontal hypometabolism at baseline. 13 of 25 had left=right metabolism at baseline or no imaging data available. There was no evidence that using baseline prefrontal hypometabolism to guide treatment location was beneficial. Treatment groups were combined for analyses.
50. Zwanzger P, Baghai TC, Padberg F, et al (2003): The combined dexamethasone-CRH test before and after repetitive transcranial magnetic stimulation (rTMS) in major depression. Psychoneuroendocrinology 28:376-85.
Study of combined dexamethasone-CRH test before and after rTMS.
51. O'Connor M, Brenninkmeyer C, Morgan A, et al (2003): Relative effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy on mood and memory: a neurocognitive risk-benefit analysis. Cogn Behav Neurol 16:118-27.
Comparison of patients receiving rTMS or ECT (unclear if patients were randomized). Patients in ECT group allowed to stay on medications; patients in rTMS group were tapered off medications. ECT patients were more depressed at baseline.
52. Brasil-Neto JP, Boechat-Barros R, da Mota-Silveira DA (2003): [The use of slow-frequency transcranial magnetic stimulation in the treatment of depression at Brasilia University Hospital: preliminary findings]. Arq Neuropsiquiatr 61:83-6. Epub 2003 Apr 16.
Three patients received open slow rTMS to the RDLPFC. 2/3 responded and 1/3 remitted. Two patients presented with psychotic features: 1 responded, 1 did not respond. Remitter did not have psychotic features and was less depressed at baseline.
53. Loo CK, Mitchell PB, Croker VM, et al (2003): Double-blind controlled investigation of bilateral prefrontal transcranial magnetic stimulation for the treatment of resistant major depression. Psychol Med 33:33-40.
No significant difference between the two groups. 2 responders in the rTMS groups, 1 responder in the sham group. 6 sham patients crossed over to rTMS; 1 pt in this group responded.
54. Grunhaus L, Schreiber S, Dolberg OT, Polak D, Dannon PN (2003): A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Biol Psychiatry 53:324-31.
No significant difference in HDRS decrease between rTMS and ECT patients. 12/20 ECT responders and 11/20 rTMS responders (>50% decr in HDRS, final HDRS <10, and final GAF >60); no significant difference between groups). 30% remission rate (final HAMD<9) in ECT and rTMS groups. For ECT group, patients received unilateral ECT initially, then bilateral ECT if no response after 6 treatments; 13 patients recv'd unilateral ECT, 7 recv'd bilateral ECT — no significant difference in response rate between these groups.
55. Nahas Z, Kozel FA, Li X, Anderson B, George MS (2003): Left prefrontal transcranial magnetic stimulation (TMS) treatment of depression in bipolar affective disorder: a pilot study of acute safety and efficacy. Bipolar Disord 5:40-7.
No significant difference between rTMS and sham in decrease in HAMD or response rate. No patients developed mania or hypomania during the study.
56. Kauffmann CD, Cheema MA, Miller BE (2004): Slow right prefrontal transcranial magnetic stimulation as a treatment for medication-resistant depression: a double-blind, placebo-controlled study. Depress Anxiety 19:59-62.
No significant difference between the groups. However, the active TMS group showed a significant reduction in HAMD over time whereas the sham group did not. Active TMS responders relapsed in 2-3 months. Sham responders relapsed in 2 weeks.
57. Fabre I, Galinowski A, Oppenheim C, et al (2004): Antidepressant efficacy and cognitive effects of repetitive transcranial magnetic stimulation in vascular depression: an open trial. Int J Geriatr Psychiatry 19:833-42.
All patients were older than 55 years and fulfilled criteria for vascular depression. Mean age 67.9 years, range 56-77 years. 5/11 patients had 25% decrease in HAMD and “almost” had a 50% decrease. Prefrontal atrophy was negatively correlated with HAMD change.
58. Hausmann A, Kemmler G, Walpoth M, et al (2004): No benefit derived from repetitive transcranial magnetic stimulation in depression: a prospective, single centre, randomised, double blind, sham controlled „add on” trial. J Neurol Neurosurg Psychiatry 75:320-2.
rTMS studied as an add-on treatment to antidepressant medication (with medication started at the start of rTMS). No significant differences between the groups. 20 Hz LPF and the combined 20 Hz LPF/1 Hz RPF active rTMS groups were combined for efficacy analyses. Unknown if patients were treatment-resistant at baseline.
59. Nahas Z, Li X, Kozel FA, et al (2004): Safety and benefits of distance-adjusted prefrontal transcranial magnetic stimulation in depressed patients 55-75 years of age: A pilot study. Depress Anxiety 19:249-56.
Study of older patients (mean age 61.2 years) with TMS intensity adjusted for prefrontal atrophy. With adjustment, treatment intensity was near 100% MT (actual intensity 114%, range 103%-141%).
60. Mosimann UP, Schmitt W, Greenberg BD, et al (2004): Repetitive transcranial magnetic stimulation: a putative add-on treatment for major depression in elderly patients. Psychiatry Res 126:123-33.
Study of rTMS in older patients (mean age 62 years).
61. Jorge RE, Robinson RG, Tateno A, et al (2004): Repetitive transcranial magnetic stimulation as treatment of poststroke depression: a preliminary study. Biol Psychiatry 55:398-405.
Study of rTMS in post-stroke depression.
62. Holtzheimer PE, 3rd, Russo J, Claypoole KH, Roy-Byrne P, Avery DH (2004): Shorter duration of depressive episode may predict response to repetitive transcranial magnetic stimulation. Depress Anxiety 19:24-30.
No significant difference between rTMS and sham; however, a significant negative correlation between length of current depressive episode and response to rTMS was found (r=-0.61, p<.05). Patients with a current episode of 4 yrs or less showed a 56% reduction in mean HAM-D whereas those with a current episode longer than 10 yrs showed only a 7% decrease.
63. Boechat-Barros R, Brasil-Neto JP (2004): Transcranial Magnetic Stimulation in depression: results of bi-weekly treatment. Rev Bras Psiquiatr 26(2):100-102.
Study of bi-weekly treatments over four weeks (8 treatments total). 50% decr in HAMD, 60% response rate, and 40% remission rate in this open study. Patients were allowed to continue on medications”.
