Efficacy of adjunctive high frequency repetitive transcranial magnetic stimulation of left prefrontal cortex in depression: a randomized sham controlled study.
OBJECTIVE
To examine the efficacy of adjunctive left prefrontal high-frequency rTMS treatment in depression patients as compared to sham stimulation.


METHODS
45 right handed moderate to severe depression patients according to ICD-10 DCR criteria were randomized to receive daily sessions of active or sham rTMS (10Hz, 90% of resting MT, 20 trains, 6s duration, 1200 pulses/day) over the right dorsolateral prefrontal cortex for 10 days. Depression and psychosis was rated using Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) and Brief Psychiatric Rating Scale (BPRS) respectively before and after rTMS.


RESULTS
For SIGH-D scores, repeated measures ANOVA showed a significant effect of treatment over time as shown by interaction effect (Pillai's Trace F [1/38] = 56.75, p<.001, η(2) = .60). For BPRS, repeated measures ANOVA showed a significant interaction effect of treatment over time (Pillai's Trace F [1/38] = 39.87, p<.001, η(2) = .51). In psychotic depression patients, repeated measures ANOVA showed a significant effect of treatment over time for SIGH-D scores (Pillai's Trace F [1/25] = 43.04, p<.001, η(2) = .63) and BPRS scores (Pillai's Trace F [1/25] = 42.17, p<.001, η(2) = .63).


CONCLUSIONS
High-frequency left prefrontal rTMS was well tolerated and found to be effective as add-on to standard pharmacotherapy in nonpsychotic as well as psychotic depression.
Ray
Sanjukta
S
Fraser Coast Integrated Mental Health Services, 185, Walker Street, Maryborough, Queensland-4650, Australia.
Nizamie
S Haque
SH
Akhtar
Sayeed
S
Praharaj
Samir Kumar
SK
Mishra
Biswa Ranjan
BR
Zia-ul-Haq
Mohammad
M
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003863:Depression / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D055815:Young Adult