title: Age predicts low-frequency transcranial magnetic stimulation efficacy in major depression.
abstract: BACKGROUND
  Transcranial magnetic stimulation (TMS) effectiveness in major depression has so far been studied mainly with high-frequency (>1 Hz) administration (HF-TMS). However, some available studies with low-frequency TMS (LF-TMS) have provided similar response rates to HF-TMS with better tolerance, but the evidence is mixed and controversial.
  
  
  METHODS
  Randomized, controlled, two arm, clinical trial. 34 Major Depression patients were randomly assigned to receive 20 sessions of real or sham TMS of the right dorsolateral prefrontal cortex as adjuvant treatment to pharmacotherapy. The main stimulation parameters were 20 trains at 110% of the motor threshold for 60 s at a frequency of 1 Hz. Blinded external evaluators administered the Hamilton Depression Rating Scale.
  
  
  RESULTS
  Both treatment groups significantly improved, although there were no statistical differences between them. In the real TMS group patients age inversely correlated with improvement of depressive symptoms at the end of the study (r=-0683 p=0.002). The percentage of decrease in scores on the Hamilton Scale was greater in subjects younger than 45 years old vs. others (41.3 +/- 22.6 vs. 15.1 +/- 15.8; t=2.8 df=16, p=0.011). These real TMS subgroups did not differ significantly in their history of previous depressive disorders, or in the refractoriness indicators of the current episode.
  
  
  CONCLUSIONS
  Small size and highly refractory sample.
  
  
  CONCLUSIONS
  Only younger patients benefited from LF-rTMS as adjuvant treatment to antidepressants in this study.
authors.affiliation: Hospital Son Dureta, Mallorca, Spain.
authors.forename: Iratxe
authors.initials: I
authors.lastname: Aguirre
authors.forename: Blanca
authors.initials: B
authors.lastname: Carretero
authors.forename: Olga
authors.initials: O
authors.lastname: Ibarra
authors.forename: Javier
authors.initials: J
authors.lastname: Kuhalainen
authors.forename: Jesús
authors.initials: J
authors.lastname: Martínez
authors.forename: Alicia
authors.initials: A
authors.lastname: Ferrer
authors.forename: Joan
authors.initials: J
authors.lastname: Salva
authors.forename: Miquel
authors.initials: M
authors.lastname: Roca
authors.forename: Margalida
authors.initials: M
authors.lastname: Gili
authors.forename: Pedro
authors.initials: P
authors.lastname: Montoya
authors.forename: Mauro
authors.initials: M
authors.lastname: Garcia-Toro
mesh_terms: D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000187:drug effects / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents