title: Relative effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy on mood and memory: a neurocognitive risk-benefit analysis.
abstract: 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.
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA. mconor@caregroup.harvard.edu
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Connor
authors.forename: Cornelia
authors.initials: C
authors.lastname: Brenninkmeyer
authors.forename: Amy
authors.initials: A
authors.lastname: Morgan
authors.forename: Kerry
authors.initials: K
authors.lastname: Bloomingdale
authors.forename: Mark
authors.initials: M
authors.lastname: Thall
authors.forename: Russell
authors.initials: R
authors.lastname: Vasile
authors.forename: Alvaro Pascual
authors.initials: AP
authors.lastname: Leone
mesh_terms: 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