title: A controlled study of repetitive transcranial magnetic stimulation as a treatment of depression in the elderly.
abstract: Rapid transcranial magnetic stimulation (rTMS) applied to the left dorsal lateral frontal cortex has been shown to produce antidepressant effects. Older depressed patients, however, in one study showed a lower response rate than younger patients. The current study examined treatment response in 20 depressed, treatment-refractory patients (mean age 60.7 +/- 9.8 years) given five sessions of rTMS at 20 Hz for 2 seconds over 20 trains at 80% of motor threshold or identical placebo stimulation, after patients had been withdrawn from their antidepressants. There were no significant differences in Hamilton Depression Scale scores either before or after treatment at 7 days' follow-up. There were three responders to active treatment and three to sham treatment and responders had significantly greater frontal lobe volume than nonresponders (p = .03). These findings suggest that the stimulation parameters used in this study were probably insufficient to produce treatment response and that frontal atrophy may interfere with the effectiveness of rTMS.
authors.affiliation: Department of Psychiatry, The University of Iowa College of Medicine, Iowa City 52242, USA.
authors.forename: F
authors.initials: F
authors.lastname: Manes
authors.forename: R
authors.initials: R
authors.lastname: Jorge
authors.forename: M
authors.initials: M
authors.lastname: Morcuende
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: S
authors.initials: S
authors.lastname: Paradiso
authors.forename: R G
authors.initials: RG
authors.lastname: Robinson
mesh_terms: D000368:Aged; D001284:Atrophy; D003866:Depressive Disorder / Q000473:pathology / Q000628:therapy*; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy; D004574:Electromagnetic Fields / Q000009:adverse effects; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome