title: A functional magnetic resonance imaging study of the effects of low frequency right prefrontal transcranial magnetic stimulation in depression.
abstract: The study aimed to explore the biological effects of low-frequency repetitive transcranial magnetic stimulation (LFR-TMS) treatment applied to the right prefrontal cortex, comparing this with the effects of high-frequency left-sided (HFL-TMS) in patients with treatment-resistant depression. Twenty-six patients with treatment-resistant depression were randomized to receive either daily LFR-TMS or HFL-TMS treatment for 3 weeks and underwent functional magnetic resonance imaging during a planning task before and after treatment. Patients responded clinically to both forms of treatment with no difference in the degree of response (F1,24 = 0.65;P > 0.05). Low-frequency repetitive transcranial magnetic stimulation resulted in no overall change in task-related activation. However, responders to LFR-TMS demonstrated a bilateral decrease in activity in middle frontal gyrus. In contrast, HFL-TMS produced an increase in activation in left precuneus with responders showing increased activation in several additional regions. Response to LFR-TMS is associated with a bilateral reduction in frontal activation that does not seem to be a nonspecific effect of treatment and differs from the response to HFL-TMS.
authors.affiliation: Alfred Psychiatry Research Centre, The Alfred and Monash University Department of Psychological Medicine, Melbourne, Victoria, Australia. paul.fitzgerald@med.monash.edu.au
authors.forename: Paul B
authors.initials: PB
authors.lastname: Fitzgerald
authors.forename: Anusha
authors.initials: A
authors.lastname: Sritharan
authors.forename: Zafiris J
authors.initials: ZJ
authors.lastname: Daskalakis
authors.forename: Anthony R
authors.initials: AR
authors.lastname: de Castella
authors.forename: Jayashri
authors.initials: J
authors.lastname: Kulkarni
authors.forename: Gary
authors.initials: G
authors.lastname: Egan
mesh_terms: D000328:Adult; D001931:Brain Mapping; D003865:Major Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism / Q000502:physiology; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017397:Prefrontal Cortex / Q000378:metabolism* / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
chemical_list: D010100:Oxygen