Unanswered Questions in the Transcranial Magnetic Stimulation Treatment of Patients With Depression

Morvai, Szabolcs; Nagy, Attila; Kovács, Attila; Móré, Csaba; Berecz, Roland; Frecska, Ede

doi:10.18071/isz.69.0004

Cited by 1 publication

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References 45 publications

(50 reference statements)

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“…According to the World Health Organization around 350 million of people suffer from depression worldwide (Morvai et al 2016). However, less than one third of depression patients reach remission after 12 weeks of initial pharmacological treatment (Trivedi et al 2006), some produce unwanted side effects (Teng et al 2017), whilst around 30% of major depressive disorder patients are diagnosed with drug treatment resistant disorder (Bewernick and Schlaepfer 2015, Fitzgerald et al 2003, Silverstein et al 2015.…”

Section: Introductionmentioning

confidence: 99%

The use of MR-less MNI based neuronavigation for 10 Hz rTMS depression therapy: electrophysiological and clinical implications

Valiulis¹,

Gerulskis²,

Dapšys³

et al. 2018

Acta Neurobiologiae Experimentalis

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Repetitive transcranial magnetic stimulation (rTMS) is a popular and effective treatment for drug resistant depression. However, there is considerable variability in clinical outcomes, in previous studies and between patients. Because of high requirements for the use of fMRI based neuronavigation, many practitioners of rTMS still choose to use a standard 5 cm rule for rTMS coil placement which leads to large variations in which brain regions are being stimulated. We decided to test the possibilities of a MNI based MR-less neuronavigation system in rTMS depression treatment, by comparing the physiological effects and clinical outcomes of 3 distinct stimulation targets. Forty-six patients (thirty-three female, thirteen male) from the Republican Vilnius psychiatric hospital, all with drug resistant depressive disorder, participated in the study. All patients received high frequency (10 Hz) stimulation for 10 to 15 daily rTMS sessions. However, before the treatment they were randomly sorted into 3 groups according to stimulation target in MNI map: Group 1 received rTMS at point-40; 48; 35; Group 2 received rTMS at point-46; 45; 38; Group 3 received rTMS at point-38; 44; 26. Electroencephalography (EEG) recordings and clinical tests were obtained the day before the rTMS course and after the last session. There were some notable differences in physiological changes between the groups, with the largest EEG band spectral power increases found in Group 1 patients and the lowest in Group 2 patients. There was a significantly larger decrease of the Hamilton Depression Rating Scale (HAM-D) scores in the Group 3 (66.94%) compared to Group 1 (57.52%) and Group 2 (56.02%). This suggests it is possible to achieve higher clinical efficacy and less physiological impact on the brain when using different targets in a neuronavigated MNI based MR-less rTMS system.

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Section: Introductionmentioning

confidence: 99%

The use of MR-less MNI based neuronavigation for 10 Hz rTMS depression therapy: electrophysiological and clinical implications

Valiulis¹,

Gerulskis²,

Dapšys³

et al. 2018

Acta Neurobiologiae Experimentalis

View full text Add to dashboard Cite

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Unanswered Questions in the Transcranial Magnetic Stimulation Treatment of Patients With Depression

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Cited by 1 publication

References 45 publications

The use of MR-less MNI based neuronavigation for 10 Hz rTMS depression therapy: electrophysiological and clinical implications

The use of MR-less MNI based neuronavigation for 10 Hz rTMS depression therapy: electrophysiological and clinical implications

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