The Efficacy and Safety of Low Frequency Repetitive Transcranial Magnetic Stimulation for Treatment-resistant Depression: The Results From a Large Multicenter French RCT

Brunelin, Jérôme; Jalenques, Isabelle; Trojak, Benoît; Attal, J.; Szekely, David; Gay, Aurélia; Januel, Dominique; Haffen, Emmanuel; Schott-Péthelaz, Anne-Marie; Brault, Coralie; Poulet, Emmanuel

doi:10.1016/j.brs.2014.07.040

Cited by 92 publications

(69 citation statements)

References 44 publications

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“…Available evidence concurs with clinical experience in suggesting that maximal effects of rTMS in MDD require 20–30 sessions of treatment, regardless of site or protocol . The limited evidence for tDCS likewise suggests that benefits continue to accumulate over 30 sessions in MDD .…”

Section: Future Directions For Nibs In Mdd and Sudssupporting

confidence: 63%

“…To date, dozens of large‐scale randomized controlled trials have confirmed efficacy for rTMS in MDD, as summarized in recent meta‐analyses . Response and remission rates in the most recent large studies are approximately 50–55% and 30–35%, respectively; real‐world effectiveness studies report similar outcomes . Course lengths of 26–28 sessions are required for maximum effect; the poorer outcomes of early trials may be attributable in part to inadequate course lengths of 5–10 sessions …”

Section: Nibs As a Treatment For Mdd/sudsmentioning

confidence: 99%

“…The most widely used rTMS protocol in MDD is high‐frequency left DLPFC stimulation. Some studies alternatively used low‐frequency right DLPFC rTMS, or both . Meta‐analyses have not found marked outcome differences between these approaches, and no one stimulation pattern appears markedly superior .…”

Section: Nibs As a Treatment For Mdd/sudsmentioning

confidence: 99%

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Noninvasive brain stimulation treatments for addiction and major depression

Dunlop

Hanlon

Downar

2016

Annals of the New York Academy of Sciences

124

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Major depressive disorder (MDD) and substance use disorders (SUDs) are prevalent, disabling, and challenging illnesses for which new treatment options are needed, particularly in comorbid cases. Neuroimaging studies of the functional architecture of the brain suggest common neural substrates underlying MDD and SUDs. Intrinsic brain activity is organized into a set of functional networks, of which two are particularly relevant to psychiatry. The salience network (SN) is crucial for cognitive control and response inhibition, and deficits in SN function are implicated across a wide variety of psychiatric disorders, including MDD and SUDs. The ventromedial network (VMN) corresponds to the classic reward circuit, and pathological VMN activity for drug cues/negative stimuli is seen in SUDs/MDD. Noninvasive brain stimulation (NIBS) techniques, including rTMS and tDCS, have been used to enhance cortico–striatal–thalamic activity through the core SN nodes in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and anterior insula. Improvements in both MDD and SUD symptoms ensue, including in comorbid cases, via enhanced cognitive control. Inhibition of the VMN also appears promising in preclinical studies for quenching the pathological incentive salience underlying SUDs and MDD. Evolving techniques may further enhance the efficacy of NIBS for MDD and SUD cases that are unresponsive to conventional treatments.

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Section: Future Directions For Nibs In Mdd and Sudssupporting

confidence: 63%

Section: Nibs As a Treatment For Mdd/sudsmentioning

confidence: 99%

See 1 more Smart Citation

Noninvasive brain stimulation treatments for addiction and major depression

Dunlop

Hanlon

Downar

2016

Annals of the New York Academy of Sciences

124

View full text Add to dashboard Cite

show abstract

“…Targeting to the other hemisphere, the right DLPFC, with rTMS can also alleviate symptoms in depression [32], substance use disorders [33], posttraumatic stress disorders [4], and panic disorders [34]. Although the left PFC seems more vulnerable to high level of cortisol, the right PFC is also involved [35].…”

Section: Modulation Of Brain Activitymentioning

confidence: 97%

Can the Effects of Noninvasive Brain Stimulation Alleviating Neuropsychiatric Symptoms Result From a Common Beneficial Regulation of the Hypothalamic-pituitary-adrenal Axis?

Fecteau¹

2015

Brain Stimulation

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“…95 One recent study found that monotherapy with low-frequency rTMS was as effective as venlafaxine plus low-frequency rTMS and venlafaxine alone for TRD; in addition, rTMS was found to be safe. 96 As opposed to standard TMS, deep TMS (dTMS) utilizes an H-shaped coil, which can modulate neuronal activity in deeper regions of the brain-up to 6 cm below the surface of the scalp. 91 For this reason, dTMS has been hypothesized as useful for treating depression.…”

Section: Anti-inflammatoriesmentioning

confidence: 99%

Towards new mechanisms: an update on therapeutics for treatment-resistant major depressive disorder

Papakostas

Ionescu

2015

Mol Psychiatry

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Depression is a devastating disorder that places a significant burden on both the individual and society. As such, the discovery of novel therapeutics and innovative treatments--especially for treatment-resistant depression (TRD)--are essential. Research into antidepressant therapies for TRD has evolved from explorations of antidepressants with primary mechanisms of action on the monoaminergic neurotransmitter system to augmentation agents with primary mechanisms both within and outside of the serotonin/norepinephrine system. Now the field of antidepressant research has changed trajectories yet again; this time, compounds with primary mechanisms of action on the glutamatergic, cholinergic and opioid systems are in the forefront of antidepressant exploration. In this review, we will discuss the most recent research surrounding these novel compounds. In addition, we will discuss novel device-based therapeutics, with a particular focus on transcranial magnetic stimulation. In many cases of antidepressant drug discovery, the role of serendipity coupled with meticulous clinical observation in drug development in medicine was crucial. Moving forward, we must look toward the combination of innovation plus improvements on the remarkable discoveries thus far to advance the field of antidepressant research.

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The Efficacy and Safety of Low Frequency Repetitive Transcranial Magnetic Stimulation for Treatment-resistant Depression: The Results From a Large Multicenter French RCT

Cited by 92 publications

References 44 publications

Noninvasive brain stimulation treatments for addiction and major depression

Noninvasive brain stimulation treatments for addiction and major depression

Can the Effects of Noninvasive Brain Stimulation Alleviating Neuropsychiatric Symptoms Result From a Common Beneficial Regulation of the Hypothalamic-pituitary-adrenal Axis?

Towards new mechanisms: an update on therapeutics for treatment-resistant major depressive disorder

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