title: A study of the effectiveness of high-frequency left prefrontal cortex transcranial magnetic stimulation in major depression in patients who have not responded to right-sided stimulation.
abstract: The objective of this study was to explore the response rate to high-frequency left-sided repetitive transcranial magnetic stimulation (rTMS) in patients who had failed to respond to right-sided low-frequency stimulation, and to investigate whether there was differential efficacy between stimulation at 5 or 10 Hz. Data from two randomized controlled trials were pooled. In both studies a group of patients were randomized to receive either 5- or 10-Hz left prefrontal rTMS after failing to respond to right-sided stimulation. These patients received blinded 5- or 10-Hz stimulation (but without a sham control) for a period of up to 4 weeks and outcomes were compared. There was a small but significant overall response to left-sided rTMS but no difference in response between the 5- and 10-Hz treatment conditions. There appears to be a significant but modest likelihood of response to left-sided TMS in patients who fail right-sided stimulation, but there is no difference in efficacy between 5- and 10-Hz stimulation.
authors.affiliation: Alfred Psychiatry Research Centre, The Alfred and Monash University Department of Psychological Medicine, Commercial Road, Melbourne, Victoria 3004, Australia. paul.fitzgerald@med.monash.edu.au
authors.forename: Paul B
authors.initials: PB
authors.lastname: Fitzgerald
authors.forename: Susan
authors.initials: S
authors.lastname: McQueen
authors.forename: Sally
authors.initials: S
authors.lastname: Herring
authors.forename: Kate
authors.initials: K
authors.lastname: Hoy
authors.forename: Rebecca
authors.initials: R
authors.lastname: Segrave
authors.forename: Jayashri
authors.initials: J
authors.lastname: Kulkarni
authors.forename: Zafiris J
authors.initials: ZJ
authors.lastname: Daskalakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001703:Biophysics; D003865:Major Depressive Disorder / Q000473:pathology* / Q000628:therapy*; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome