title: 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.
abstract: 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.
authors.affiliation: Unite de recherche clinique, EPS de Ville Evrard a Saint Denis, G03, 5 Rue du Dr Delafontaine 93200 Saint-Denis, France. urcve@freesurf.fr
authors.forename: Dominique
authors.initials: D
authors.lastname: Januel
authors.forename: Gilles
authors.initials: G
authors.lastname: Dumortier
authors.forename: Claire-Marie
authors.initials: CM
authors.lastname: Verdon
authors.forename: Laurence
authors.initials: L
authors.lastname: Stamatiadis
authors.forename: Ghassen
authors.initials: G
authors.lastname: Saba
authors.forename: Wanda
authors.initials: W
authors.lastname: Cabaret
authors.forename: René
authors.initials: R
authors.lastname: Benadhira
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Rocamora
authors.forename: Sonia
authors.initials: S
authors.lastname: Braha
authors.forename: Khalid
authors.initials: K
authors.lastname: Kalalou
authors.forename: Pr Eric
authors.initials: PE
authors.lastname: Vicaut
authors.forename: J
authors.initials: J
authors.lastname: Fermanian
mesh_terms: 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