title: Improvement in quality of life with left prefrontal transcranial magnetic stimulation in patients with pharmacoresistant major depression: acute and six month outcomes.
abstract: BACKGROUND
  Transcranial magnetic stimulation (TMS) is a safe and effective treatment for major depression. We describe quality of life (QOL) outcomes from acute treatment with TMS, and describe the durability of benefit across 24-weeks.
  
  
  METHODS
  Three hundred and one medication-free patients with pharmacoresistant major depression were randomized to active or sham TMS in a 6-week controlled trial. Nonresponders to the 6-week blinded phase of the study were enrolled in a 6-week open-label study without unblinding the prior treatment assignment. Responders and partial responders to both the blinded (active or sham treatment) or open acute treatment phases were tapered off TMS over three weeks, while initiating maintenance antidepressant medication monotherapy. These subjects entered the 24-week study to examine the durability of response to TMS. The Medical Outcomes Study-36 Item Short Form (SF-36) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) were used to measure overall function and QOL. During the 24-week durability of effect study, QOL assessments were done at study entry and at the end of 24-weeks.
  
  
  RESULTS
  Statistically significant improvement in both functional status and QOL outcomes was observed in patients treated with active TMS compared with sham TMS during the acute phase of the randomized, sham-controlled trial. Similar benefits were observed in patients who entered the open-label extension study. These improvements were sustained across the 24-week follow up study.
  
  
  CONCLUSIONS
  Acute treatment with TMS improved functional status and QOL outcomes in patients with major depression. This clinical effect was durable in long-term follow up.
authors: Department of Psychiatry, Stanford University Medical Center, Stanford University, 401 Quarry Road, Palo Alto, CA 94305 USA. Electronic address: solvason@mac.com.
authors: H B
authors: HB
authors: Solvason
authors: University of Texas Southwestern Medical School, Dallas, TX, USA.
authors: M
authors: M
authors: Husain
authors: The Alfred Hospital, Melbourne, Australia.
authors: P B
authors: PB
authors: Fitzgerald
authors: Medical College of Georgia, Augusta, GA, USA.
authors: P
authors: P
authors: Rosenquist
authors: Medical College of Georgia, Augusta, GA, USA.
authors: W V
authors: WV
authors: McCall
authors: Wake Forest University, Winston-Salem, NC, USA.
authors: J
authors: J
authors: Kimball
authors: Northwestern University, Chicago, IL, USA.
authors: W
authors: W
authors: Gilmer
authors: Neuronetics, Inc., Malvern, PA, USA.
authors: M A
authors: MA
authors: Demitrack
authors: Duke University, Durham, NC, USA.
authors: S H
authors: SH
authors: Lisanby
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006801:Humans; D010549:Personal Satisfaction; D011788:Quality of Life; D019233:Retreatment; D011795:Surveys and Questionnaires; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressant; Clinical trial; Major depression; Quality of life; TMS; Treatment resistance