A double-blind sham controlled study of right prefrontal repetitive transcranial magnetic stimulation (rTMS): Therapeutic and cognitive effect in medication free unipolar depression during 4 weeks

• Published in: Progress in neuro-psychopharmacology & biological psychiatry 2006, Vol.30 (1), p.126-130
• Main Authors: Januel, Dominique, Dumortier, Gilles, Verdon, Claire-Marie, Stamatiadis, Laurence, Saba, Ghassen, Cabaret, Wanda, Benadhira, René, Rocamora, Jean-François, Braha, Sonia, Kalalou, Khalid, Vicaut, Pr Eric, Fermanian, J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Analysis of Variance; Biological and medical sciences; Cognition - radiation effects; Depression; Depressive Disorder - therapy; Double-Blind Method; Double-blind study; Female; Functional Laterality; Humans; Male; Medical sciences; Middle Aged; Mood disorders; Neuropsychological Tests - statistics & numerical data; Patient Compliance; Prefrontal cortex; Prefrontal Cortex - physiopathology; Prefrontal Cortex - radiation effects; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Time Factors; TMS-treatment; Transcranial Magnetic Stimulation - methods; Treatment Outcome; Unipolar depression
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2005.08.016

Transcranial magnetic stimulation (TMS) has become a therapeutic tool in psychiatric diseases. The objective was to evaluate the efficacy of TMS in unipolar depression: the percentage of responders (> 50% HDRS reduction) and remission (HDRS score ≤ 8, after four weeks of active TMS treatment in depressed patients free of any antidepressive agent versus placebo-TMS. 27 patients were randomized in two groups: rTMS ( N = 11) versus sham TMS ( N = 16). Statistical differences were detected between sham and TMS treated groups on remission (0 / 16 versus 4 / 11 p = 0.032, 1 / 16 versus 6 / 11 0.028 and 1 / 16 versus 7 / 11 p = 0.011 at day 14, day 21 and day 28, respectively) and on response (2 / 16 versus 5 / 11 at day 14 (NS), 2 / 16 versus 7 / 11 p = 0.0115 at day 21 and 1 / 16 versus 7 / 11 ( p = 0.025) day 28, respectively, using the exact Fisher test). Significant differences were observed between day 1 versus day 8 ( p < 0.01), day 15, day 21 and day 28 ( p < 0.001) in TMS group and only versus day 21 ( p < 0.01) and day 28 ( p < 0.05) for the sham group. ANOVA comparison between TMS and sham groups was significant at day 14 and day 28 ( p < 0.05). The few number of patients. Our study has shown an efficacy of right rTMS in free medication unipolar depression over a month. Nevertheless, number of patients included is limited and multicentric studies will be necessary to specify the antidepressive action of TMS.