title: Transcranial magnetic stimulation in treatment-resistant depressed patients: a double-blind, placebo-controlled trial.
abstract: This 5-week, randomized, double-blind, placebo-controlled trial investigated the efficacy and tolerability of high frequency repetitive transcranial magnetic stimulation (rTMS) directed to the left prefrontal cortex in drug-resistant depressed patients. Fifty-four patients were randomly assigned to receive 10 daily applications of either real or sham rTMS. Subjects assigned to receive active stimulation were divided into two further subgroups according to the intensity of stimulation: 80% vs. 100% of motor threshold (MT). At study completion, the response rates were 61.1% (n=11), 27.8% (n=5) and 6.2% (n=1) for the 100% MT group, 80% MT group and sham group, respectively. A significant difference (Pearson chi(2) test) was found between the 100% MT and sham groups, while the 80% MT group did not differ significantly from the sham group. Between the two active groups, a marginally significant difference was observed. Analysis of variance with repeated measures on Hamilton Depression Rating Scale scores revealed a significantly different decrease over time of depressive symptomatology among the three treatment groups. Treatment response appeared to be unrelated to the demographic and clinical characteristics recorded, and on the whole the technique was well tolerated. The results of this double-blind trial showed that rTMS may be a useful and safe adjunctive treatment for drug-resistant depressed patients.
authors.affiliation: Department of Psychiatry, School of Medicine, Vita-Salute University, San Raffaele Hospital, via Stamira d'Ancona 20, Milan 20127, Italy. rossini.david@hsr.it
authors.forename: David
authors.initials: D
authors.lastname: Rossini
authors.forename: Adelio
authors.initials: A
authors.lastname: Lucca
authors.forename: Raffaella
authors.initials: R
authors.lastname: Zanardi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Magri
authors.forename: Enrico
authors.initials: E
authors.lastname: Smeraldi
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004292:Dominance, Cerebral / Q000502:physiology*; D004311:Double-Blind Method; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D017397:Prefrontal Cortex / Q000503:physiopathology; D011594:Psychometrics; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents