Actigraphy in Patients With Major Depressive Disorder Undergoing Repetitive Transcranial Magnetic Stimulation: An Open Label Pilot Study.
BACKGROUND
The effects of repetitive transcranial magnetic stimulation (rTMS) on physical activity and sleep patterns in individuals with major depressive disorder (MDD) remain unclear.


METHODS
We examined the effects of rTMS treatment on the rest-activity cycle and sleep disturbances in MDD. In this open-label pilot study, 14 patients with medication-resistant MDD underwent 10 rTMS sessions over the bilateral dorsolateral prefrontal cortex. In addition to Hamilton Depression Rating Scale and Pittsburgh Sleep Quality Index scores, waist actigraphy was used to evaluate alterations in the rest-activity cycle over the course of rTMS treatments. Actigraphic data were evaluated at baseline and in the first (rTMS sessions 1-3), second (rTMS sessions 4-7), and third (rTMS sessions 8-10) sections.


RESULTS
Although Hamilton Depression Rating Scale and Pittsburgh Sleep Quality Index scores were significantly improved by rTMS, sleep variables assessed by actigraphy did not show significant changes. However, post hoc tests indicated a significant increase in mean steps per day between the baseline and first section time points (P = 0.014; t13 = -2.316).


CONCLUSIONS
Our data indicated that a daytime physical activity response to rTMS occurred in early sessions, whereas subjective symptom improvements were consistent across all sessions. Future double-blind placebo-controlled studies assessing the effects of rTMS on the rest-activity cycle and sleep disturbances in MDD are warranted.
From the *Department of Psychiatry, Jichi Medical University, Shimotsuke, Japan; †Sleep and Circadian Neurobiology Laboratory, Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA; and ‡Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan.
Masaki
M
Nishida
Senichiro
S
Kikuchi
Koichi
K
Nisijima
Shiro
S
Suda
D056044:Actigraphy; D000328:Adult; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000628:therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012890:Sleep; D050781:Transcranial Magnetic Stimulation