Bilateral prefrontal rTMS and theta burst TMS as an add-on treatment for depression: A randomized placebo controlled trial. (January 2015)

• Record Type: Journal Article
• Authors: Prasser, Julia; Schecklmann, Martin; Poeppl, Timm B.; Frank, Elmar; Kreuzer, Peter M.; Hajak, Goeran; Rupprecht, Rainer; Landgrebe, Michael; Langguth, Berthold
• Is Part Of: World journal of biological psychiatry. Volume 16:Number 1(2015)
• Page Start: 57
• Page End: 65
• Publication Date: 2015-01
• Subjects: Biological psychiatry -- Periodicals; Biological Psychiatry -- Periodicals; 616.89
• DOI: 10.3109/15622975.2014.964768
• Languages: English
• ISSNs: 1562-2975

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives.</italic> Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral-prefrontal cortex (DLPFC) exerts antidepressant effects. In this randomised controlled clinical trial we aimed to test the safety and therapeutic efficacy of bilateral theta-burst stimulation (TBS) as an add-on therapy to standard treatment of major depression. <italic>Methods.</italic> Fifty-six patients diagnosed with a moderate to severe depressive episode received 15 daily treatments of either rTMS (110% motor-threshold; rightDLPFC, 1000 stimuli at 1 Hz + leftDLPFC, 1000 stimuli at 10 Hz), theta-burst stimulation (80% motor-threshold; rightDLPFC, continuous TBS, 1200 stimuli + leftDLPFC, intermittent TBS, 1200 stimuli), or sham TMS (<italic>N = </italic>17, sham coil with the TBS protocol). <italic>Results.</italic> There was no significant effect in the primary outcome measures (change of the 21-item Hamilton Rating Scale for Depression). However, there was a tendency towards an increased responder rate at the end of the follow-up period for both active treatments as compared to sham, and this tendency was most pronounced for the TBS group. <italic>Conclusions.</italic> This pilot study did not reveal significant advantages of bilateral TBS or rTMS over sham treatment as an add-on treatment for major depression. A tendency towards a superior effect of bilateral TBS at the end of the follow-up period may warrant further studies.</p> </abstract>