Low-frequency rTMS inhibits the anti-depressive effect of ECT. A pilot study. Issue 6 (27th December 2020)

• Record Type: Journal Article
• Authors: Buchholtz, Poul Erik; Ashkanian, Mahmoud; Hjerrild, Simon; Hauptmann, Line Kirstine; Devantier, Torben Albert; Jensen, Paulina; Wissing, Sanne; Thorgaard, Mette Viller; Bjerager, Laerke; Lund, Julie; Alrø, Anja Johnsen; Speed, Maria Simonsen; Brund, Rene Børge Korsgaard; Videbech, Poul
• Is Part Of: Acta neuropsychiatrica. Volume 32:Issue 6(2020)
• Page Start: 328
• Page End: 338
• Publication Date: 2020-12-27
• Subjects: low-frequency transcranial magnetic stimulation (rTMS), -- electroconvulsive therapy (ECT), -- depression, -- randomised trial; Neuropsychiatry -- Periodicals; 616.89
• DOI: 10.1017/neu.2020.28
• Languages: English
• ISSNs: 0924-2708

Abstract

Abstract: Objective: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects. Methods: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out. Results: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group. Conclusion: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.