A double-blind sham controlled study of right prefrontal repetitive transcranial magnetic stimulation (rTMS): therapeutic and cognitive effect in medication free unipolar depression during 4 weeks.
BACKGROUND
Transcranial magnetic stimulation (TMS) has become a therapeutic tool in psychiatric diseases.


METHODS
The objective was to evaluate the efficacy of TMS in unipolar depression: the percentage of responders (>50% HDRS reduction) and remission (HDRS score < or =8, after four weeks of active TMS treatment in depressed patients free of any antidepressive agent versus placebo-TMS.


RESULTS
27 patients were randomized in two groups: rTMS (N=11) versus sham TMS (N=16). Statistical differences were detected between sham and TMS treated groups on remission (0/16 versus 4/11 p=0.032, 1/16 versus 6/11 0.028 and 1/16 versus 7/11 p=0.011 at day 14, day 21 and day 28, respectively) and on response (2/16 versus 5/11 at day 14 (NS), 2/16 versus 7/11 p=0.0115 at day 21 and 1/16 versus 7/11 (p=0.025) day 28, respectively, using the exact Fisher test). Significant differences were observed between day 1 versus day 8 (p<0.01), day 15, day 21 and day 28 (p<0.001) in TMS group and only versus day 21 (p<0.01) and day 28 (p<0.05) for the sham group. ANOVA comparison between TMS and sham groups was significant at day 14 and day 28 (p<0.05).


CONCLUSIONS
The few number of patients.


CONCLUSIONS
Our study has shown an efficacy of right rTMS in free medication unipolar depression over a month. Nevertheless, number of patients included is limited and multicentric studies will be necessary to specify the antidepressive action of TMS.
Januel
Dominique
D
Unite de recherche clinique, EPS de Ville Evrard a Saint Denis, G03, 5 Rue du Dr Delafontaine 93200 Saint-Denis, France. urcve@freesurf.fr
Dumortier
Gilles
G
Verdon
Claire-Marie
CM
Stamatiadis
Laurence
L
Saba
Ghassen
G
Cabaret
Wanda
W
Benadhira
René
R
Rocamora
Jean-François
JF
Braha
Sonia
S
Kalalou
Khalid
K
Vicaut
Pr Eric
PE
Fermanian
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003071:Cognition / Q000528:radiation effects*; D003866:Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010349:Patient Compliance; D017397:Prefrontal Cortex / Q000503:physiopathology / Q000528:radiation effects*; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome