Can left prefrontal rTMS be used as a maintenance treatment for bipolar depression?
Numerous studies have examined the acute antidepressant effects of prefrontal transcranial magnetic stimulation (TMS). However, there is little information on whether TMS can be used as a maintenance treatment to maintain normal mood once subjects have responded. We describe seven adults with bipolar depression who responded acutely to TMS and were then treated with TMS weekly for up to 1 year. TMS was carried out over the left prefrontal cortex at 110% motor threshold, 5 Hz for 8 s for 40 trains. Three subjects completed 1 full year of weekly TMS with an average Hamilton Rating Scale for Depression of 13 (sd = 5.9) over the year. These data suggest but do not prove that TMS might eventually be used as an adjunctive maintenance treatment for at least some patients with bipolar depression. Much work remains.
Li
Xingbao
X
Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Room 502 North, PO Box 250861, Charleston, SC 29425, USA. lixi@musc.edu
Nahas
Ziad
Z
Anderson
Berry
B
Kozel
F Andrew
FA
George
Mark S
MS
D000328:Adult; D000339:Affect / Q000187:drug effects / Q000502:physiology; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D008280:Magnetics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017397:Prefrontal Cortex / Q000503:physiopathology*; D055502:Secondary Prevention
D000927:Anticonvulsants; D000928:Antidepressive Agents