title: Repetitive transcranial magnetic stimulation in patients with drug-resistant major depression: A six-month clinical follow-up study.
abstract: OBJECTIVE
  In this study we aimed to assess the long-term efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) on depressive symptoms and cognitive performance in patients with drug-resistant major depressive disorder (MDD).
  
  
  METHODS
  Fifteen drug-resistant depressed outpatients completed an acute trial with augmentative high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC) and were compared with 15 drug-resistant MDD patients who underwent sham procedure. Depressive symptoms were evaluated with the Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale. The Frontal Assessment Battery and the Stroop Color-Word Test Interference (Stroop T) were used to probe executive functions. Outcome measures were obtained at baseline, 4 weeks after the rTMS, as well as 3 months and 6 months after the end of the stimulation protocol.
  
  
  RESULTS
  After the active rTMS, patients showed a significant decrease in the scores at the depression rating scales that lasted for 6 months. A transient improvement was also observed at the Stroop T, although it did not persist in time.
  
  
  CONCLUSIONS
  High-frequency rTMS over the left DLPFC may have long-term antidepressant effect in drug-resistant MDD. TMS is a valuable tool for the add-on treatment of mood disorders and for the design of customized stimulation protocols.
authors.affiliation: a Department of Clinical and Experimental Medicine , Psychiatry Unit, University of Catania , Via Santa Sofia, Catania , Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Concerto
authors.affiliation: a Department of Clinical and Experimental Medicine , Psychiatry Unit, University of Catania , Via Santa Sofia, Catania , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lanza
authors.affiliation: b Department of Neurology I.C. , "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.) . Via Conte Ruggero, Troina (EN) , Italy.
authors.forename: Mariagiovanna
authors.initials: M
authors.lastname: Cantone
authors.affiliation: b Department of Neurology I.C. , "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.) . Via Conte Ruggero, Troina (EN) , Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
authors.affiliation: c Department "Specialità Medico-Chirurgiche" , University of Catania , Via Santa Sofia, Catania , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pennisi
authors.affiliation: d Department of Medical and Surgical Sciences and Advanced Technologies , Section of Neurosciences , Via Santa Sofia, Catania , Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Bella
authors.affiliation: a Department of Clinical and Experimental Medicine , Psychiatry Unit, University of Catania , Via Santa Sofia, Catania , Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Aguglia
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000628:therapy*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017397:Prefrontal Cortex / Q000503:physiopathology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: Cortical excitability; drug-resistant major depression; neural plasticity; repetitive TMS