Effect of repetitive TMS and fluoxetine on cognitive function in patients with Parkinson's disease and concurrent depression.
Previous studies show that cognitive functions are more impaired in patients with Parkinson's disease (PD) and depression than in nondepressed PD patients. We compared the cognitive effects of two types of antidepressant treatments in PD patients: fluoxetine (20 mg/day) versus repetitive transcranial magnetic stimulation (rTMS, 15 Hz, 110% above motor threshold, 10 daily sessions) of the left dorsolateral prefrontal cortex. Twenty-five patients with PD and depression were randomly assigned either to Group 1 (active rTMS and placebo medication) or to Group 2 (sham rTMS and fluoxetine). A neuropsychological battery was assessed by a rater blind to treatment arm at baseline and 2 and 8 weeks after treatment. Patients in both groups had a significant improvement of Stroop (colored words and interference card) and Hooper and Wisconsin (perseverative errors) test performances after both treatments. Furthermore, there were no adverse effects after either rTMS or fluoxetine in any neuropsychological test of the cognitive test battery. The results show that rTMS could improve some aspects of cognition in PD patients similar to that of fluoxetine. The mechanisms for this cognitive improvement are unclear, but it is in the context of mood improvement.
Boggio
Paulo S
PS
Department of Experimental Psychology, Institute of Psychology, University of Sao Paulo, Sao Paulo, SP, Brazil.
Fregni
Felipe
F
Bermpohl
Felix
F
Mansur
Carlos G
CG
Rosa
Moacyr
M
Rumi
Demetrio O
DO
Barbosa
Egberto R
ER
Odebrecht Rosa
Marina
M
Pascual-Leone
Alvaro
A
Rigonatti
Sérgio Paulo
SP
Marcolin
Marco A
MA
Araujo Silva
Maria Teresa
MT
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D010507:Periodicity; D017397:Prefrontal Cortex / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D050781:Transcranial Magnetic Stimulation / Q000295:instrumentation*
D000978:Antiparkinson Agents; D005473:Fluoxetine; D007980:Levodopa; D017367:Selective Serotonin Reuptake Inhibitors