A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression

Grunhaus, Leon; Schreiber, Shaul; Dolberg, Ornah T.; Polak, Dana; Dannon, Pinhas N.

doi:10.1016/s0006-3223(02)01499-3

Cited by 208 publications

(116 citation statements)

References 40 publications

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“…We believe that our studies (36,37) and that of Janicak et al (39), in which rTMS was used for patients who were not taking antidepressant medication, should stand along with those of Berman's (33) and George's (34) groups described earlier in bolstering the case for rTMS as a stand-alone therapy. One feature that sets these studies and that of Pridmore et al (38) apart is the long treatment course.…”

Section: Ect-controlled Studiesmentioning

confidence: 56%

“…But among nonpsychotic patients, both treatments met with similar success rates, with six (60%) of 10 patients responding to ECT and seven (64%) of 11 responding to rTMS (36). In a follow-up study (37), only patients with nonpsychotic major depression for whom 4 weeks of antidepressant pharmacotherapy had failed were included. In the ECT group, 60% of patients responded, compared with 55% in the rTMS group (37).…”

Section: Ect-controlled Studiesmentioning

confidence: 99%

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Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

Self Cite

452

246

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Objective: Transcranial magnetic stimulation (TMS) is a noninvasive and easily tolerated method of altering cortical physiology. The authors evaluate evidence from the last decade supporting a possible role for TMS in the treatment of depression and explore clinical and technical considerations that might bear on treatment success. Method:The authors review English-language controlled studies of nonconvulsive TMS therapy for depression that appeared in the MEDLINE database through early 2002, as well as one study that was in press in 2002 and was published in 2003. In addition, the authors discuss studies that have examined technical, methodological, and clinical treatment parameters of TMS. Results:Most data support an antidepressant effect of high-frequency repetitive TMS administered to the left prefrontal cortex. The absence of psychosis, younger age, and certain brain physiologic markers might predict treatment success. Technical parameters possibly affecting treatment success include intensity and duration of treatment, but these suggestions require systematic testing.Conclusions: TMS shows promise as a novel antidepressant treatment. Systematic and large-scale studies are needed to identify patient populations most likely to benefit and treatment parameters most likely to produce success. In addition to its potential clinical role, TMS promises to provide insights into the pathophysiology of depression through research designs in which the ability of TMS to alter brain activity is coupled with functional neuroimaging. (Am J Psychiatry 2003; 160:835-845)In 1831, Michael Faraday discovered that electrical currents can be converted into magnetic fields and vice versa. His principle of mutual induction is the basis of transcranial magnetic stimulation (TMS). In TMS, a bank of capacitors is rapidly discharged into an electric coil to produce a magnetic field pulse (Figure 1). When the coil is placed near the head of a human or animal, the magnetic field penetrates the brain and induces an electric field in the underlying region of the cerebral cortex (4) (Figure 2). An electrical field of sufficient intensity will depolarize cortical neurons, generating action potentials. These then propagate to exert their biological effects. For example, TMS over the left motor cortex causes action potentials that propagate through the corticospinal tract, causing twitches in contralateral skeletal muscles.This new technology has been used to affect underlying brain tissue at several levels. First, TMS can alter regional activity within the cortex. Positron emission tomography (PET) has revealed changes in cortical metabolism and dose-dependent changes in regional cortical blood flow in response to TMS (5-7). Such changes are also observed at sites distant from the magnetic stimulus, showing that the effects of TMS propagate to other parts of the brain (6, 7). The connections demonstrated in this manner correspond to known neural pathways in nonhuman primates, suggesting that the propagation of TMS effects occurs by means of...

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Section: Ect-controlled Studiesmentioning

confidence: 56%

Section: Ect-controlled Studiesmentioning

confidence: 99%

Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

Self Cite

452

246

View full text Add to dashboard Cite

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“…Grunhaus et al 110 and Janicak et al 112 suggest that the transcranial magnetic stimulation and ECT reach similar results in nonpsychotic major depressive disorder. According to the meta-analysis by Martin et al 113 there is no strong evidence of the benefits of using transcranial magnetic stimulation to treat depression, although the small sample sizes do not exclude possible positive effects.…”

Section: Efficacymentioning

confidence: 92%

“…In the present review, we have also found five RCT [108][109][110][111][112] and a systematic review about transcranial magnetic stimulation, which have been tested and introduced as a new method of convulsive therapy. Its main principle consists of the rapid alternation of strong magnetic fields.…”

Section: Efficacymentioning

confidence: 99%

Evidências da eficácia da eletroconvulsoterapia na prática psiquiátrica

Moser

Lobato

Belmonte-de-Abreu

2005

Rev. psiquiatr. Rio Gd. Sul

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A eletroconvulsoterapia (ECT) consiste em tratamento biológico ainda não amplamente utilizado na prática psiquiátrica, devido aos inúmeros fatores que contribuem para uma resistência acerca do método. Objetivando sustentar, com embasamento científico, o emprego da ECT, agregamos evidências de sua eficácia, indicações, contra-indicações e efeitos adversos, advindas dos principais ensaios clínicos randomizados e meta-análises disponíveis na literatura médica atual sobre o tema (PubMed/MEDLINE, Cochrane).

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“…A later study by the same group used a similar method in 40 patients with severe depression without psychotic features. 17 The initial results were replicated, with an overall efficacy of 58% and no significant difference between treatments. Janicak et al randomized severely depressed patients to rTMS or ECT, with no significant difference in efficacy between the two treatments in 22 patients (rTMS-55%, ECT-64%).…”

Section: Rtms Versus Ectmentioning

confidence: 96%

Terapias somáticas para transtornos psiquiátricos resistentes ao tratamento

Braga

Petrides²

2007

Rev. Bras. Psiquiatr.

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A b s t r a c t Objective: This paper reviews the current knowledge of somatic treatment in psychiatry, with a focus on treatment-resistant psychiatric disorders. Method: A computerized search of the literature was conducted on Medline using the words "electroconvulsive therapy", "transcranial magnetic stimulation", "vagus nerve stimulation", "deep brain stimulation", and "magnetic seizure therapy". References from each paper were also screened. Results: The development of new non-pharmacological psychiatric interventions in the past decades has renewed the clinical and research interest in somatic therapies. Although electroconvulsive therapy remains the only somatic treatment with undisputed efficacy; transcranial magnetic stimulation, vagus nerve stimulation and deep brain stimulation all offer potential as novel means of psychiatric treatment. Conclusions: New treatment modalities still have an insufficient body of data. Notwithstanding, biological strategies continue to hold promise as a safer and more effective approach to psychiatric treatment. Descriptors: Brain diseases; Electroconvulsive therapy; Transcranial magnetic stimulation; Vagus nerve; Deep brain stimulationResumo Objetivo: O presente artigo é uma revisão do conhecimento atual relativo às terapias somáticas em psiquiatria, com foco em transtornos psiquiátricos resistentes ao tratamento usual. Método: Foi realizada uma pesquisa computadorizada da literatura no Medline utilizando as palavras "eletroconvulsoterapia", "estimulação magnética transcraniana ", "terapia magnética convulsiva", "estimulação do nervo vago" e "estimulação cerebral profunda", com todos os termos traduzidos para o idioma inglês. Referên-cias listadas em cada artigo foram também analisadas. Resultados: O desenvolvimento de novos tratamentos psiquiátricos não farmacológicos nas últimas décadas renovou o interesse em terapias somáticas. A despeito de a eletroconvulsoterapia continuar a ser o único tratamento somático com eficácia estabelecida, a estimulação magnética transcraniana, a terapia magnética convulsiva, a estimulação do nervo vago e a estimulação cerebral profunda são potencialmente novas modalidades de tratamento psiquiátrico. Conclusões: Novas modalidades de tratamento ainda padecem de falta de conhecimento cientifico adequado. Entretanto, estratégias somáticas ainda representam uma promessa como formas mais eficazes e seguras de tratamento psiquiátrico.

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A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression

Cited by 208 publications

References 40 publications

Transcranial Magnetic Stimulation in the Treatment of Depression

Transcranial Magnetic Stimulation in the Treatment of Depression

Evidências da eficácia da eletroconvulsoterapia na prática psiquiátrica

Terapias somáticas para transtornos psiquiátricos resistentes ao tratamento

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