No Change in Neuropsychological Functioning After Receiving Repetitive Transcranial Magnetic Stimulation Treatment for Major Depression

Abstract

Early studies of transcranial magnetic stimulation (TMS) have shown no adverse effects on neuropsychological function. However, further research is needed using higher TMS intensities, a greater number of TMS pulses, and larger sample sizes. We studied 68 patients with Major Depressive Disorder who were randomized to receive either 15 sessions of sham or real TMS at 110% of the estimated prefrontal cortex threshold to the left dorsolateral prefrontal cortex. Each session consisted of 32 5-second trains of 10 Hz repetitive TMS at 110% adjusted motor threshold. A total of 24,000 pulses were given. Neuropsychological function was assessed before and immediately after TMS treatment with a battery of 8 tests. Using a higher TMS intensity, a greater number of pulses and a larger sample size compared to most previous studies, this study found no negative neuropsychological effects of TMS. Changes in neuropsychological function were unrelated to changes in depression.

Effect of repetitive transcranial magnetic stimulation (rTMS) treatment of major depressive disorder (MDD) on cognitive control

“…rTMS therefore may represent a more promising treatment strategy for those patients suffering from concomitant cognitive dysfunction in MDD. Our finding of modest improvement in cognitive control tasks is consistent with previous studies that found improvement of executive function following rTMS treatment (Moser et al, 2002;Noda, Zomorrodi, Backhouse, et al, 2017;Noda, Zomorrodi, Saeki, et al, 2017), along with improvement in other domains including verbal memory (Kuroda et al, 2006;Fitzgerald et al, 2009;Wajdik et al, 2014) and attention (Höppner et al, 2003;O'Connor et al, 2005;Naim-Feil et al, 2016).…”

“…Repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (DLPFC) has been shown to be a safe and efficacious alternative for treatment resistant depression (George et al, 2010;Carpenter et al, 2012). There is preliminary evidence showing that rTMS could also improve cognitive function in MDD including verbal memory (Kuroda et al, 2006;Fitzgerald et al, 2009;Wajdik et al, 2014), attention (Höppner et al, 2003;O'Connor et al, 2005;Naim-Feil et al, 2016), and executive function (Moser et al, 2002); cf. (Salagre et al, 2017).…”

Two Versus One High-Frequency Repetitive Transcranial Magnetic Stimulation Session per Day for Treatment-Resistant Depression

“…First, raters and "treaters", though blind to the study protocol, were from the same academic center. Second, we were not able to evaluate cognitive function; however, several studies have indicated that rTMS is relatively safe in this domain 25,61 . Third, the follow-up period was short because we did not want TRD patients to remain untreated for longer periods.…”

Cognitive Enhancement in Neurological and Psychiatric Disorders Using Transcranial Magnetic Stimulation (TMS): A Review of Modalities, Potential Mechanisms and Future Implications

“…The underactivation is coupled with lower cerebral blood flow to the prefrontal cortex, which results in the disturbance of its key function which is higher thinking and executive functioning. The application of rTMS to the left DLPFC may act as an enhancer to the deficit of the prefrontal areas including activation and cerebral blood flow, and has shown to improve memories of those under depression and PTSD in various domains including episodic memory, spatial memory, verbal fluency, and executive function [5167686970]. rTMS treatment in depression has also demonstrated improved attentional control including the trail-making test and Stroop interference task [74546677071727374].…”