Response to deep TMS in depressive patients with previous electroconvulsive treatment.
BACKGROUND
The efficacy of transcranial magnetic stimulation (TMS) in the treatment of major depression has already been shown. Novel TMS coils allowing stimulation of deeper brain regions have recently been developed and studied.


OBJECTIVE
Our study is aimed at exploring the possible efficacy of deep TMS in patients with resistant depression, who previously underwent electroconvalsive therapy (ECT).


METHODS
Using Brainsway's deep TMS H1 coil, six patients who previously underwent ECT, were treated with 120% power of the motor threshold at a frequency of 20 Hz. Patients underwent five sessions per week, up to 4 weeks. Before the study, patients were evaluated using the Hamilton depression rating scale (HDRS, 24 items), the Hamilton anxiety scale, and the Beck depression inventory and were again evaluated after 5, 10, 15, and 20 daily treatments. Response to treatment was considered a reduction in the HDRS of at least 50%, and remission was considered a reduction of the HDRS-24 below 10 points.


RESULTS
Two of six patients responded to the treatment with deep TMS, including one who achieved full remission.


CONCLUSIONS
Our results suggest the possibility of a subpopulation of depressed patients who may benefit from deep TMS treatment, including patients who did not respond to ECT previously. However, the power of the study is small and similar larger samples are needed.
The Beer Ya'acov Mental Health Institution, Beer Ya'acov, Israel. oded.rosenberg@beerness.health.gov.il
Oded
O
Rosenberg
Abraham
A
Zangen
Rafael
R
Stryjer
Moshe
M
Kotler
Pinhas N
PN
Dannon
D000328:Adult; D003866:Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D050781:Transcranial Magnetic Stimulation / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome