An open study of repetitive transcranial magnetic stimulation in treatment-resistant depression with Parkinson’s disease

• Published in: Clinical neurophysiology 2007-10, Vol.118 (10), p.2189-2194
• Main Authors: Epstein, Charles M, Evatt, Marian L, Funk, Agnes, Girard-Siqueira, Lhys, Lupei, Nichole, Slaughter, Larisa, Athar, Saima, Green, Joanne, McDonald, William, DeLong, Mahlon R
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Antidepressive Agents - therapeutic use; Biological and medical sciences; Data Interpretation, Statistical; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Depression; Depressive Disorder - etiology; Depressive Disorder - psychology; Depressive Disorder - therapy; Drug Resistance; Feasibility Studies; Female; Humans; Inpatients; Male; Medical sciences; Middle Aged; Mood disorders; Movement - physiology; Neurology; Neuropsychological Tests; Parkinson disease; Parkinson Disease - complications; Parkinson Disease - psychology; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Transcranial magnetic stimulation; Transcranial Magnetic Stimulation - adverse effects
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2007.07.010

Abstract Objective Major depression is a common concomitant of chronic central nervous system disorders, notably Parkinson’s disease (PD). Repetitive transcranial magnetic stimulation (rTMS) has been investigated as a potential treatment for depression in PD and for the movement disorder of PD, but comprehensive testing in multiple areas of performance has seldom been carried out within a single study. We studied the effect of left dorsolateral prefrontal rTMS on several different functional domains. Methods Fourteen PD patients with treatment-resistant depression entered an open, 10-day inpatient study of 10-Hz rTMS, undergoing extensive psychiatric, neuropsychological, and motor testing from baseline to 6 weeks after treatment. Motor testing included a defined “off” state. Results rTMS was well tolerated. Highly significant improvement in depression scores was seen 3 days and 3–6 weeks after treatment. Improvement was also found in anxiety, movement scores (especially in the off state), and some neuropsychological measures. We found no evidence of increased risk from rTMS in this population. Conclusions Further controlled trials of rTMS in PD appear worthwhile, and should include a defined “off” state. Significance TMS may be beneficial for depressed PD patients in multiple functional domains.