Relative effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy on mood and memory: a neurocognitive risk-benefit analysis.
OBJECTIVE
Two procedures for treating major depressive disorder were compared with regard to their respective effects on mood and cognition.


BACKGROUND
Fourteen patients underwent treatment with electroconvulsive therapy and 14 underwent treatment with repetitive transcranial magnetic stimulation. Patients were tested on three occasions: before initiation of treatment, at the end of treatment, and 2 weeks after the end of treatment.


METHODS
Electroconvulsive therapy was applied unilaterally approximately three times per week for 2 to 4 weeks. Repetitive transcranial magnetic stimulation was applied in sessions of 1600 stimuli at 10 Hertz and 90% of motor threshold intensity to the left dorsolateral prefrontal cortex daily (Monday through Friday) for 2 consecutive weeks.


RESULTS
Results indicate that electroconvulsive therapy had a more positive effect on mood than did a 2-week trial of repetitive transcranial magnetic stimulation. With regard to cognitive outcome measures, electroconvulsive therapy exerted a deleterious but transient effect on various components of memory that were no longer detected 2 weeks after the end of treatment; however, there was evidence of persistent retrograde amnesia after treatment with electroconvulsive therapy. As a group, repetitive transcranial magnetic stimulation patients experienced only a modest reduction in depression severity but there was no evidence of anterograde or retrograde memory deficits in the aftermath of treatment with repetitive transcranial magnetic stimulation.


CONCLUSIONS
Findings suggest that electroconvulsive therapy is associated with transient negative cognitive side effects, most of which dissipate in the days after treatment. Deficits of this sort are not apparent after treatment with a 2-week course of repetitive transcranial magnetic stimulation.
O'Connor
Margaret
M
Harvard Medical School, Boston, Massachusetts, USA. mconor@caregroup.harvard.edu
Brenninkmeyer
Cornelia
C
Morgan
Amy
A
Bloomingdale
Kerry
K
Thall
Mark
M
Vasile
Russell
R
Leone
Alvaro Pascual
AP
D000339:Affect; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D006801:Humans; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D018570:Risk Assessment; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome