Repetitive transcranial magnetic stimulation: a putative add-on treatment for major depression in elderly patients

Daily Left Prefrontal Repetitive Transcranial Magnetic Stimulation in the Acute Treatment of Major Depression: Clinical Predictors of Outcome in a Multisite, Randomized Controlled Clinical Trial

“…The Extended Active TMS group also was more likely to have a current episode of greater than 2 years in duration than the Sham to TMS group, further complicating the comparison. We failed to replicate prior reports that age was a negative predictor of outcome (Figiel et al, 1998;Fregni et al, 2006;Manes et al, 2001;Mosimann et al, 2002Mosimann et al, , 2004Su et al, 2005). Notably, patients that were X55 showed a similar response as younger patients.…”

“…However, not all studies are positive (Boutros et al, 2002;Cohen et al, 2003;Hansen et al, 2004;Hausmann et al, 2004;Loo et al, 1999;Loo et al, 2003;Mosimann et al, 2004) and earlier studies were hampered by small sample sizes and other limitations. A recent meta-analysis argues that the improved design (dose, length of treatment) of recent studies (Avery et al, 2006;Fitzgerald et al, 2003Fitzgerald et al, , 2006 is associated with larger treatment effects than work before 2000 (Gross et al, 2007).…”

“…Patient-related factors emerging as being related to response to TMS include duration of current episode (Brakemeier et al, 2007;Holtzheimer et al, 2004), medication resistance (Brakemeier et al, 2007;Fregni et al, 2006), and age (Figiel et al, 1998;Fregni et al, 2006;Manes et al, 2001;Mosimann et al, 2002Mosimann et al, , 2004Su et al, 2005). Fregni et al (2006) reported that younger age and less prior treatment resistance was associated with better response to TMS.…”

“…Increasing the distance from the coil to the target cortex decreases the intensity of the stimulation reaching the brain, which is negatively correlated with antidepressant response and with the degree of stimulation-induced brain activation (Kozel et al, 2000;Mosimann et al, 2002;Nahas et al, 2001). The impact of atrophy on coil-to-cortex distance has been posited to contribute to reduced efficacy in the elderly (Figiel et al, 1998;Fregni et al, 2006;Manes et al, 2001;Mosimann et al, 2002Mosimann et al, , 2004Su et al, 2005). Adjusting dose to overcome atrophy may result in better effects in the elderly (Nahas et al, 2004).…”

Intérêt de la TMS au long cours au sein d’une population de patients âgés déprimés résistants

“…Il semble en effet qu'en plus de l'atrophie corticale et des comorbidités somatiques, le taux de réponse dans cette population dépende plus M a n u s c r i p t 7 particulièrement de la durée du traitement. Concernant les performances cognitives, nos résultats confirment les données des études précédentes qui montrent l'innocuité, voire l'effet procognitif de la TMS dans cette population de patients déprimés de plus de 60 ans [2,4,9].…”