title: Maintenance Deep Transcranial Magnetic Stimulation Sessions are Associated with Reduced Depressive Relapses in Patients with Unipolar or Bipolar Depression.
abstract: BACKGROUND
  Deep transcranial magnetic stimulation (dTMS) is a new form of TMS allowing safe stimulation of deep brain regions. The objective of this preliminary study was to assess the role of dTMS maintenance sessions in protecting patients with bipolar disorder (BD) or recurrent major depressive disorder (MDD) from developing depressive or manic relapses in a 12-month follow-up period.
  
  
  METHODS
  Twenty-four drug-resistant patients with a current depressive episode and a diagnosis of MDD or BD have been enrolled in the study. All the participants underwent daily dTMS sessions for 4 weeks. One group (maintenance - M group) received additional maintenance dTMS sessions weekly or twice a week.
  
  
  RESULTS
  After the first dTMS cycle, a significant reduction of Hamilton Depression Rating Scale (HDRS) scores was observed in all participants. Subsequently, the HDRS mean scores did not significantly change over time in the M group, while it significantly increased in the non-M-group after 6 and 12 months.
  
  
  CONCLUSIONS
  This study confirms previous evidence of a positive therapeutic effect of dTMS on depressive symptoms and suggests that, after recovery from acute episodes, maintenance dTMS sessions may be helpful in maintaining euthymia in a 12-month follow-up period.
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy ; Neuropsychiatric Unit, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus , Viterbo , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rapinesi
authors.affiliation: Department of Neurology and Psychiatry, Policlinico Umberto I University Hospital, Sapienza University of Rome , Rome , Italy.
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Bersani
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy.
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Kotzalidis
authors.affiliation: Department of Human Sciences, European University of Rome , Rome , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Imperatori
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy ; Department of Psychiatric Rehabilitation, P. Alberto Mileno Onlus Foundation , Vasto , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Casale
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Di Pietro
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy ; Neuropsychiatric Unit, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus , Viterbo , Italy.
authors.forename: Vittoria R
authors.initials: VR
authors.lastname: Ferri
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Serata
authors.affiliation: ATID Ltd - Advanced Technology Innovation Distribution , Rome , Italy.
authors.forename: Ruggero N
authors.initials: RN
authors.lastname: Raccah
authors.affiliation: Department of Life Sciences, Ben Gurion University of the Negev , Be'er Sheva , Israel.
authors.forename: Abraham
authors.initials: A
authors.lastname: Zangen
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Angeletti
authors.affiliation: Department of Neurosciences, Mental Health, and Sensory Organs NESMOS, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy ; Neuropsychiatric Unit, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus , Viterbo , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
keywords: bipolar disorder; brain modulation; deep transcranial magnetic stimulation; neuropsychiatry; recurrent major depressive disorder