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A randomized controlled trial with 4-month follow-up of adjunctive repetitive transcranial magnetic stimulation of the left prefrontal cortex for depression.
Psychol Med. 2008 Mar; 38(3):323-33.PM

Abstract

BACKGROUND

Effectiveness of repetitive transcranial magnetic stimulation (rTMS) for major depression is unclear. The authors performed a randomized controlled trial comparing real and sham adjunctive rTMS with 4-month follow-up.

METHOD

Fifty-nine patients with major depression were randomly assigned to a 10-day course of either real (n=29) or sham (n=30) rTMS of the left dorsolateral prefrontal cortex (DLPFC). Primary outcome measures were the 17-item Hamilton Depression Rating Scale (HAMD) and proportions of patients meeting criteria for response (50% reduction in HAMD) and remission (HAMD8) after treatment. Secondary outcomes included mood self-ratings on Beck Depression Inventory-II and visual analogue mood scales, Brief Psychiatric Rating Scale (BPRS) score, and both self-reported and observer-rated cognitive changes. Patients had 6-week and 4-month follow-ups.

RESULTS

Overall, Hamilton Depression Rating Scale (HAMD) scores were modestly reduced in both groups but with no significant groupxtime interaction (p=0.09) or group main effect (p=0.85); the mean difference in HAMD change scores was -0.3 (95% CI -3.4 to 2.8). At end-of-treatment time-point, 32% of the real group were responders compared with 10% of the sham group (p=0.06); 25% of the real group met the remission criterion compared with 10% of the sham group (p=0.2); the mean difference in HAMD change scores was 2.9 (95% CI -0.7 to 6.5). There were no significant differences between the two groups on any secondary outcome measures. Blinding was difficult to maintain for both patients and raters.

CONCLUSIONS

Adjunctive rTMS of the left DLPFC could not be shown to be more effective than sham rTMS for treating depression.

Authors+Show Affiliations

Section of Old Age Psychiatry, Institute of Psychiatry, King's College London, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17935639

Citation

Mogg, A, et al. "A Randomized Controlled Trial With 4-month Follow-up of Adjunctive Repetitive Transcranial Magnetic Stimulation of the Left Prefrontal Cortex for Depression." Psychological Medicine, vol. 38, no. 3, 2008, pp. 323-33.
Mogg A, Pluck G, Eranti SV, et al. A randomized controlled trial with 4-month follow-up of adjunctive repetitive transcranial magnetic stimulation of the left prefrontal cortex for depression. Psychol Med. 2008;38(3):323-33.
Mogg, A., Pluck, G., Eranti, S. V., Landau, S., Purvis, R., Brown, R. G., Curtis, V., Howard, R., Philpot, M., & McLoughlin, D. M. (2008). A randomized controlled trial with 4-month follow-up of adjunctive repetitive transcranial magnetic stimulation of the left prefrontal cortex for depression. Psychological Medicine, 38(3), 323-33.
Mogg A, et al. A Randomized Controlled Trial With 4-month Follow-up of Adjunctive Repetitive Transcranial Magnetic Stimulation of the Left Prefrontal Cortex for Depression. Psychol Med. 2008;38(3):323-33. PubMed PMID: 17935639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized controlled trial with 4-month follow-up of adjunctive repetitive transcranial magnetic stimulation of the left prefrontal cortex for depression. AU - Mogg,A, AU - Pluck,G, AU - Eranti,S V, AU - Landau,S, AU - Purvis,R, AU - Brown,R G, AU - Curtis,V, AU - Howard,R, AU - Philpot,M, AU - McLoughlin,D M, Y1 - 2007/10/15/ PY - 2007/10/16/pubmed PY - 2008/5/6/medline PY - 2007/10/16/entrez SP - 323 EP - 33 JF - Psychological medicine JO - Psychol Med VL - 38 IS - 3 N2 - BACKGROUND: Effectiveness of repetitive transcranial magnetic stimulation (rTMS) for major depression is unclear. The authors performed a randomized controlled trial comparing real and sham adjunctive rTMS with 4-month follow-up. METHOD: Fifty-nine patients with major depression were randomly assigned to a 10-day course of either real (n=29) or sham (n=30) rTMS of the left dorsolateral prefrontal cortex (DLPFC). Primary outcome measures were the 17-item Hamilton Depression Rating Scale (HAMD) and proportions of patients meeting criteria for response (50% reduction in HAMD) and remission (HAMD8) after treatment. Secondary outcomes included mood self-ratings on Beck Depression Inventory-II and visual analogue mood scales, Brief Psychiatric Rating Scale (BPRS) score, and both self-reported and observer-rated cognitive changes. Patients had 6-week and 4-month follow-ups. RESULTS: Overall, Hamilton Depression Rating Scale (HAMD) scores were modestly reduced in both groups but with no significant groupxtime interaction (p=0.09) or group main effect (p=0.85); the mean difference in HAMD change scores was -0.3 (95% CI -3.4 to 2.8). At end-of-treatment time-point, 32% of the real group were responders compared with 10% of the sham group (p=0.06); 25% of the real group met the remission criterion compared with 10% of the sham group (p=0.2); the mean difference in HAMD change scores was 2.9 (95% CI -0.7 to 6.5). There were no significant differences between the two groups on any secondary outcome measures. Blinding was difficult to maintain for both patients and raters. CONCLUSIONS: Adjunctive rTMS of the left DLPFC could not be shown to be more effective than sham rTMS for treating depression. SN - 0033-2917 UR - https://www.unboundmedicine.com/medline/citation/17935639/A_randomized_controlled_trial_with_4_month_follow_up_of_adjunctive_repetitive_transcranial_magnetic_stimulation_of_the_left_prefrontal_cortex_for_depression_ DB - PRIME DP - Unbound Medicine ER -